Small Tobadex eye epidemic treat inflammation in the eye (5ml)

Dosage form Bottle x 5ml
Specifications Tobramycin, dexamethasone

Ingredient

Thành phần cho 1ml

Composition information	Content
Tobramycin	0.3%
Dexamethasone	0.1%

Uses

indications

Tobadex eye drops are indicated in the following cases:

Treatment of eye inflammation in the eye response to steroids that are indicated to use corticosteroids and when the eye infections in the eye are caused by bacteria or at risk of bacterial eye infections.

Treatment in the mi -eyelids and conjunctivitis, keratitis and the front of the eyeball when accepting the inherent risk of the use of steroids in conjunctivitis to reduce inflammation and edema.

Treatment of chronic pharyngitis and corneal damage caused by chemicals, radiation, thermal burns or foreign objects.

is indicated for treatment when there is a high risk of superficial infections in the eye or when there is a prediction of the possibility of a large number of bacteria present in the eye.

The antibacterial ingredient in this drug has the following common anti -bacterial activity in the eye:

• Staphylococci, including S. Aureus and S. Epidermidis (positive coagulase and negative coagulase), including penicillin strains.

• Streptococci, including some blood -soluble beta species, some species do not cause hemolysis, and some streptococcus pneumoniae.

• Pseudomonas Aeruginosa, Escherichia Coli, Klebsiella Pneumoniae, Entobacter Aerogenes, Proteus Mirabilis. Morganella Morganii, most Proteus Vulgaris, Haemophilus Influenza and H. Aegyptius, Moraxella Lacunata, and Acinetobacter Calcoaceticus (Herelea Vaginacola) and some Neisseria species.

Pharmacology

Pharmaceutical Group: combination of anti -inflammatory and antibiotic drugs - Corticosteroid and antibiotic combination.

dexamethason

Dexamethason is a corticosteroid with distinct anti -inflammatory activity with lower mineralocorticoid activity than other cortioids. Corticosteroids effectively anti -inflammatory through inhibition of endothelial adhesion molecules, cyclooxygenase I or II and cytokine effects.

These effects are peaked with reducing the impact of inflammatory mediators and inhibiting leukocyte adhesion to the endothelial blood vessel, thus preventing their migration into inflamed eye tissue.

Tobramycin

Mechanism of action:

Tobramycin is an antibacterial aminoglycoside. The main effect on bacterial cells by inhibiting the synthesis and assembly of polypeptide chains in ribosome.

Medicinal resistance mechanism:

The resistance to Tobramycin occurs by a number of different mechanisms including: (1) Changes of ribosome subunits in bacterial cells; (2) Having obstacles with the transportation of tobramycin into the cell and (3) inactivating tobramycin with enzyme fences, adenylation, phosphorylation, and acetylation. Genetic information to produce inactive enzymes can be transmitted through bacterial chromosomes or plasmids. Diagonal resistance may occur with other aminoglycosides.

pharmacokinetics

dexamethason

After small eyes are small, Tobradex eyes, the whole body absorption of low dexamethasone. The maximum concentration in plasma is about 220-888 PG/ml with an average CMAX value of 555 ± 217 PG/ml (average ± deviation, standard after dripping a small Tobadex eye mixture every 4 times/day, for 2 consecutive days).

In rabbits, the concentration in the aquarium of dexamethason after the small eye of the Tobadex eye is observed early at 30 minutes and reached the peak at 60 minutes with an average value of 69.4 ± 21.6 ng/ml (cmax).

Oral bioavailability of human and normal patients is 70-80%. After intravenous injection, the whole body clearance is 0.125 l/h/kg and the distribution volume in a stable state is 0.58 l/kg. Half-life excreted is 3-4 hours but in men a little longer.

This difference is not changing the body clearance but creates a difference in distribution and body quantity. After using the whole body, 2.6% of the drug is found in the form of unchanged urine, while 60% of the dose is found in the form of metabolites 6 -hydroxydexamethasone and 5 -10% found in other metabolic forms are 6β-hydroxy-20-diydrodexamethasone.

Tobramycin

Studies performed with Tobadex eye drops show that after eye drops, the body absorption of Tobramycin is low. The plasma concentration of Tobramycin in 9/12 patients used a small drop of Tobadex eye, 4 times/day, for 2 consecutive days, under the quantitative limit.

The highest concentration in plasma when using a single dose is 0.25 µg/ml is determined at 1.5 hours after drinking, 8 times lower than the concentration of Tobramycin 2 µg/ml-known as the threshold at risk of toxicity on the kidney.

Tobramycin is mainly eliminated in the country in the form of non -constant glomerular filtration. Half -life eliminated in the acupuncture point is about 2 hours, with the clearance of 0.04 l/h/kg and the distribution volume is 0.26 l/kg. The ratio of plasma proteins of Tobramycin is below 10%. Oral bioavailability is less than 1%.

Before taking Small Tobadex eye epidemic treat inflammation in the eye (5ml)

How to use

only use eye.

Shake thoroughly before use.

After opening the lid, if the attachment is removed, it is necessary to remove it before taking the drug.

To avoid the infection at the small tip of the drug and the drug chaos, it is necessary to be careful not to put the medications of the vial to touch the eyelids, the area around the eyes or other surfaces. Close the lid of the vial when not in use.

Should press the turbulent tube or close your eyes slightly after small eyes. This can reduce the body absorption of the drug through the eye and help reduce the unwanted effect.

If you are taking more than one eye drops, the drugs must be used at least 5 minutes apart. Eye ointment needs to be used final.

Dosage

Small 1 or 2 drops in the conjunctiva bag every 4-6 hours.

In the first 24 to 48 hours, the dose can be increased to 1 or 2 drops every 2 hours.

Small frequency of drugs should be gradually reduced when clinical symptoms are improved, should be very careful to avoid sudden treatment.

Tobadex eye ointment can be used before bedtime in combination with small Tobadex eye fluid during the day.

When starting, you should not be prescribed more than 20 ml and should not be prescribed without further evaluation as stated in the special warning section and caution when using the drug.

Use in children:

Not yet established the safety and effectiveness of the Tobadex eye small chewing in children.

Used in patients with liver or renal failure:

Not yet established the safety and effectiveness of Tobadex eye small chaos in patients with liver failure or renal failure.

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?

Due to the characteristics of the preparation, there is no toxicity when the eye is overdose or when swallowing a bottle of medicine into the digestive tract.

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 Tobadex, you may experience unwanted effects (ADR).

The following unwanted effects are determined through clinical and monitoring studies after circulation.

Uncommon, 1/1000

Eyes: glaucoma, eye pain, itchy eye, discomfort in the eyes, eye irritation.

Rare, 1/10000

Eyes: corneal inflammation, eye allergy, blurred vision, dry eyes, eye congestion.

Digestive: Change taste.

Not determined frequency

immune: hypersensitivity.

Neurology: dizziness, headache.

Eyes: eyelid edema, red eyelids, dilated pupils, increasing tears.

Digestive: Nausea, abdominal discomfort.

Skin and subcutaneous tissues: skin rash, swelling, itching.

Describe some unwanted effects

Using corticosteroids in the eye can lead to glaucoma with the ability to progress of glaucoma and optic nerve damage, visual loss and market deficiency, causing cataracts under the following bags and slowing wound recovery (see special warning and caution when taking drugs).

Due to the corticosteroid ingredient, with diseases that thin the cornea or the strength, it is easy to cause puncture of those parts, especially after a long time of treatment (see special warning and caution when taking the drug).

The development of secondary infections has occurred after a combination drug containing corticosteroids and antibacterial. Special corneal fungal infections are easily developed along with prolonged use of corticosteroids (see special and cautious warnings when taking the drug).

There have been serious unwanted effects including neurotoxicity, hearing and kidney toxicity on patients treated with systemic sugar toBramycin (see special and kidney warning.

In some patients, there may be sensitivity to local aminoglycosides (see special and cautious warnings when taking the drug). The most unwanted effects with Tobramycin. (Tobrex) Used at the eye is toxicity at the eye and hypersensitivity, including itching and swelling of the eyelids, redness. These unwanted effects occur in

Instructions on how to handle ADR

Notify the doctor with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Tobadex drugs contraindicated in the following cases:

Hypersensitivity to tobramycin, dexamethasone or any ingredients of the drug.

Herpes Simplex is caused by herpes Simplex.

Beef, chickenpox and other virus infections in the cornea or conjunctiva.

Fungal diseases of the eye structure.

TB infections in the eye.

Always contraindicated to the small Tobadex eyes after surgery to remove unpleasant cornea.

Be cautious when using

not injected into the eye.

There may be sensitive phenomenon with aminoglycosides used in the spot in some patients. If hypersensitivity occurs, need to stop taking the drug.

may occur cross -sensitive with other aminoglycosides, which should be considered for patients who are sensitive to local and/ other body aminoglycosides, or other body can also be sensitive to topical tobramycin.

There have been serious unwanted effects including neurotoxicity, hearing and kidney toxicity in patients with tri -tri with aminoglycosides of systemic sugar. Should be cautious when using these drugs and should monitor the total plasma concentration.

Using prolonged eye corticosteroids can lead to glaucoma and/ or glaucoma, with optic nerve damage, vision and market reduction, and cause cataracts under the following bags.

Should monitor the pressure (IOP) periodically and regularly for patients to treat corticoids in the eye. This is especially important for children because of the risk of glaucoma using corticosteroids in children may be higher and occur earlier than adults. Do not use small Tobadex eye chaos for children.

The risk of glaucoma due to the use of corticosteroids and/ or opaque glass increases in infected patients (for example: diabetes).

corticosteroids can reduce resistance and facilitate infection, fungal or viral infections and cover the clinical signs of the disease.

It is necessary to consider the possibility of fungal infections in patients with prolonged corneal ulcer and should stop corticosteroid treatment immediately when infected with fungal infection. For a long time, antibiotics such as Tobramycin can lead to excessive growth of non -sensitive microorganisms, including mushrooms. If superinfection occurs, the appropriate symptom treatment should be started.

corticosteroids in place in the eye can slow down the restoration of corneal wounds. It is known that the use of anti -inflammatory drugs steroids (NSAIDs) also slows down or delayed the recovery of wounds. Simultaneous use of nonsteroidal and local steroid anti -inflammatory drugs may increase the risk of wound recovery (see interactive items with other drugs and other forms of interactions).

For thinning or thinning diseases, there is a puncture of those parts after using local corticosteroids.

Do not recommend wearing contact lenses while treating eye inflammation or eye infection. Tobalkonium chloride is small, containing benzalkonium chloride that can cause soft contact lenses. Avoid contact with soft contact lenses. In the case of patients who are allowed to wear contact lenses, they need to be instructed to remove contact lenses before the Tobadex eye is small and wait at least 15 minutes before wearing again.

When required to take a lot of drugs or when any clinical decision is required, the patient should be checked with the support of exaggerated devices, such as the microscope and the appropriate fluorescent dye.

The ability to drive and operate machinery

Tobadex small eye has no influence or significant impact on the ability to drive and operate machinery.

However, temporary blurring or other vision disorders can affect the ability to drive or operate machinery. If you are blurred after eye examination, the patient must wait until it is clearly visible and operate machinery.

Pregnancy

fertility

There is no evaluation of the influence of the Tobadex eye small chaos on fertility.

pregnancy

Data on the use of Tobramycin or Dexamethasone eye drops in pregnant women is still not available or limited. Animal studies with corticosteroids and systematic toblamycin shows that the drug is toxic on reproduction.

There is no recommendation to use Tobadex eye small chewed during pregnancy.

Breastfeeding period

It is unclear whether Tobramycin and Dexamethason are used to look for excreted eyes through breast milk or not. Corticosteroids and bodyburges are excreted in breast milk. The risk for breastfeeding is not excluded.

Need the price of benefits of breastfeeding with babies and the benefits of treatment for mothers to decide whether to stop breastfeeding or stop or avoid using Tobadex small eye.

Drug interactions

Tocidal use in place with non -steroid anti -inflammatory drugs (NSAIDs) on -site may increase the risk of corneal wound recovery.

Storage

Store at a temperature not exceeding 30 ° C.

Other drugs

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