Anauran

Anauran is a combination drug that contains three active components:

1. Polymyxin B sulfate is an antibiotic that is commonly used to treat infections caused by gram-negative bacteria. Polymyxin B has a bactericidal effect, destroying the cell membranes of bacteria and preventing their growth and reproduction.
2. Neomycin sulfate is another antibiotic that is also used to treat infections caused by bacteria. Neomycin interferes with the synthesis of bacterial proteins, which leads to their death.
3. Lidocaine hydrochloride is a local anesthetic that is used to reduce pain when treating infections or procedures in the area where the drug is applied.

Anauran is commonly used in the treatment of outer ear infections caused by bacteria such as Pseudomonas aeruginosa, Escherichia coli and other gram-negative organisms. It is used as topical ear drops.

Indications Anaurana

1. Acute otitis externa (otitis externa) is an infection of the outer ear, often caused by bacterial pathogens. Anauran may be prescribed for the treatment of acute external otitis, especially if the infection is caused by gram-negative bacteria.
2. Ear infections - the drug can be used to treat other ear infections caused by bacteria, especially if they are gram-negative organisms.

Release form

Anauran is available as topical ear drops. Drops are usually supplied in bottles with a convenient dispenser for easy and precise administration of the drug into the outer ear.

Pharmacodynamics

1. Polymyxin B sulfate: Polymyxin B is an antibiotic from the polymyxin group that has a bactericidal effect. It affects gram-negative bacteria, including Pseudomonas aeruginosa, Escherichia coli and others. The mechanism of action of polymyxin B is to disrupt the cytoplasmic membrane of bacteria, which leads to their death.
2. Neomycin sulfate: Neomycin is also an antibiotic that inhibits protein synthesis in bacteria. This is achieved by binding neomycin to the 30S subunit of the bacterial ribosome, which prevents aminoacyl-tRNA from binding to mRNA and thereby inhibits protein synthesis.
3. Lidocaine Hydrochloride: Lidocaine is a local anesthetic that works by blocking sodium channels in nerve cells and preventing the transmission of pain signals. As part of Anauran, lidocaine is used to provide an analgesic effect and relieve discomfort during ear infections.

Pharmacokinetics

1. Polymyxin B Sulfate and Neomycin Sulfate: When Anauran is injected topically into the outer ear, Polymyxin B and Neomycin Sulfate can slowly penetrate through the eardrum into the middle ear and further into the tissues where they can exert their antibacterial effects. They are usually not absorbed into the bloodstream in sufficient quantities to act systemically, reducing the risk of systemic side effects.
2. Lidocaine hydrochloride: Lidocaine is usually rapidly absorbed through mucous membranes into ear bleeds. It acts quickly, providing local anesthesia and reducing pain in the ear cavity. After topical application, lidocaine is quickly metabolized in the liver and excreted from the body through the kidneys.

Dosing and administration

1. Before using this medicine, be sure to consult your doctor or pharmacist. They can give you individual recommendations, taking into account your health condition and treatment characteristics.
2. Clean your ear of any discharge or debris. To do this, you can use a soft cotton swab or napkin.
3. Put the required number of drops into the outer ear. To do this, tilt your head so that your ear is vertical and place a few drops inside the ear.
4. After introducing the drops, lightly massage the area around the ear with gentle movements. This will help distribute the drug evenly inside the ear.
5. Follow your doctor's instructions regarding frequency and duration of use. Typically, the drops are prescribed several times a day for a specified period of time, which may vary depending on the nature of the infection and response to treatment.
6. Do not exceed the recommended dose. Compliance with the recommended dosage will help avoid side effects and overdoing.
7. After use, close the bottle with a cap and store it out of the reach of children.

Use Anaurana during pregnancy

1. Polymyxin B:

   • Polymyxin B may have neuromuscular blocking effects, which are potentially harmful when used in high doses, especially in vulnerable populations such as pregnant women. Polymyxin B has been shown to cause respiratory paralysis when administered intravenously (Small, 1964).
   • Animal studies have shown that polymyxin B may interfere with normal embryonic development and increase the risk of congenital anomalies when administered during pregnancy (Jaiswal et al., 2011).

2. Neomycin sulfate:

   • Neomycin may reduce estrogen excretion in pregnant women, which may interfere with normal hormonal balance during pregnancy (Pulkkinen & Willman, 1973).
   • When applied topically, neomycin may cause contact sensitization, which may be a problem for some pregnant women (Booth et al., 1994).

3. Lidocaine hydrochloride:

   • Lidocaine is used as a local anesthetic and is considered relatively safe when used in moderate doses. However, its combination with other components such as polymyxin B and neomycin may require caution due to possible additive toxic effects (Wright & Collier, 1976).

Contraindications

1. Individual intolerance: Any of the components of Anauran can cause an allergic reaction in the patient. If you have a known allergy to these substances, the use of the drug is contraindicated.
2. Damage to the eardrum: The use of topical eardrops, including Anauran, is contraindicated in the presence of a damaged eardrum, as this may allow the drug to penetrate into the middle ear and cause infection.
3. Acute purulent middle ear infection: In the presence of an acute purulent middle ear infection, systemic antibiotic treatment may be required, and the use of topical drops such as Anauran may not be sufficient.
4. In-ear implant use: The use of topical drops may be contraindicated in patients with in-ear implants or other ear surgery.
5. Children's age: For children, the use of drops should be carried out with extreme caution and under the supervision of a physician.
6. Pregnancy and breastfeeding: The use of Anauran during pregnancy and breastfeeding requires an assessment of the benefits and risks and should be carried out under the supervision of a physician.
7. Previous reactions to local anesthetics: If the patient has a known allergy or previous adverse reactions to local anesthetics such as lidocaine, the use of Anauran may be contraindicated.

Side effects Anaurana

1. Allergic reactions: Include skin rash, itching, hives, swelling of the face, throat or tongue, difficulty breathing and anaphylactic shock. If any allergic reactions occur, you must immediately stop using the drug and seek medical help.
2. Ear irritation: Temporary symptoms of ear irritation, such as redness, itching, tingling, or discomfort in the ear cavity, may occur.
3. Hearing impairment: Some patients may notice temporary hearing impairment after using topical drops. Usually this phenomenon goes away on its own, but it is important to tell your doctor about it.
4. Gastrointestinal disorders: Rare cases of irritation or discomfort in the stomach or intestines may occur.
5. Systemic side effects: Although systemic absorption of the active components when applied topically with Anauran is usually minimal, systemic side effects associated with antibiotics or local anesthetics are theoretically possible.
6. Hersensitivity to the components of the drug: Individual reactions to one of the components of the drug may cause hypersensitivity, which will lead to various undesirable effects.

Overdose

Overdose of topical application of Anauran (ear drops) is unlikely due to low systemic absorption of the active components. However, if the drug is accidentally swallowed or used in large quantities, unwanted side effects are possible.

Signs of overdose may include an increase or intensification of side effects such as allergic reactions, irritation or redness of the skin in the ear area, as well as possible systemic effects associated with lidocaine (a local anesthetic), such as drowsiness, dizziness, arrhythmia and even seizures.

Interactions with other drugs

1. Other topical ear medications: Using multiple topical medications at the same time may increase the risk of developing irritation or allergic reactions in the ear cavity. Before using other ear medications simultaneously with Anauran, it is recommended to consult a doctor.
2. Systemic antibiotics: Since polymyxin B and neomycin, which are part of Anauran, are used topically, their systemic interaction with other antibiotics is usually minimal. However, if the patient is taking systemic antibiotics to treat other infections, it is important to tell the doctor.
3. Local anesthetics: The use of lidocaine, which is part of Anauran, with other local anesthetics may increase the risk of toxicity, especially when using large doses or with increased sensitivity to anesthetics.
4. Drugs that increase the risk of allergic reactions: If you are allergic to any components of Anauran or other drugs that increase the risk of allergic reactions, you should be careful when using them simultaneously to avoid the development of allergic complications.