Dermokas

Dermokas is an active corticosteroid that is combined with other drugs.

Indications Dermokasa

It is used in the treatment of dermatoses that can be eliminated with the help of GCS, as well as complicated (or if there is a suspicion of a complication) by a secondary form of infection caused by bacteria that are sensitive to the elements of the drug.

It is also used for fungal pathologies developing on the surface of the skin and caused by the activity of yeast fungi or dermatophytes (mycosis in the foot area, pityriasis versicolor lichen, epidermophytosis in the groin area and other skin lesions of fungal etiology).

Release form

It is released in the form of a cream, in tubes of 10 or 20 g. A separate pack contains 1 such tube.

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Pharmacodynamics

Gentamicin is an antibiotic with a wide range of medicinal activity, included in the category of aminoglycosides. It has a bactericidal effect, promotes highly effective local therapy for skin infections of bacterial nature, both primary and secondary.

Shows activity in relation to:

• gram-negative microbes – Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Proteus and Klebsiella pneumoniae;
• gram-positive microorganisms - streptococci (strains of α-, as well as β-hemolytic streptococci from category A, sensitive to the action of the drug) and Staphylococcus aureus (coagulase-negative and -positive bacteria, as well as individual strains that produce penicillinase).

Miconazole has antifungal properties - it suppresses the processes of ergostyrene biosynthesis, and also changes the lipid structure of membranes, which causes the fungal cells to die.

The substance exhibits an antifungal effect against dermatophytes (red trichophyton, interdigital trichophyton, flocculent epidermophyton and downy microsporum), yeast and yeast-like fungi (Candida albicans), and other pathogenic fungi (Malassezia furfur, black aspergillus and Penicillium crustosum). In addition, it affects individual gram-positive microbes (streptococci with staphylococci).

The betamethasone element has antipruritic, anti-inflammatory, and in addition antiallergic and glucocorticoid properties. After local application of the drug, this component eliminates itching, has a vasoconstrictive effect, reduces the secretion volumes of inflammation conductors (from labrocytes with eosinophils), IL-1 and IL-2, as well as γ-interferon (from macrophages with lymphocytes). At the same time, it slows down the activity of hyaluronidase and strengthens the strength of vascular membranes.

It interacts with specific endings inside the cell cytoplasm, stimulates the process of RNA binding, causes the formation of proteins (including lipocortin), mediating cellular reactions. Lipocortin inhibits the activity of phospholipase A2, and at the same time blocks the ability of arachidonic acid to liberation, as well as the biosynthesis of PG, endoperoxides and leukotrienes, which lead to the development of inflammatory processes, allergy symptoms and other pathogenic reactions.

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Pharmacokinetics

After local application, the drug is almost not absorbed into the bloodstream.

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Dosing and administration

The affected area is treated with a thin layer of medicinal cream. The procedure is performed twice a day (in the morning and then at night). To achieve the desired effect, it is necessary to use Dermokas regularly. The duration of therapy is determined by the location and size of the pathogenic lesion, as well as the patient's response to the therapy.

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Use Dermokasa during pregnancy

It is prohibited to prescribe Dermokas during lactation or pregnancy.

Contraindications

Among the contraindications:

• cutaneous tuberculosis, skin manifestations caused by vaccination, as well as symptoms of syphilis that appear on the skin;
• plaque psoriasis (widespread), perioral dermatitis, chickenpox and rosacea;
• varicose veins;
• infectious diseases of viral origin (including HIV) and other infections of bacterial or fungal origin developing on the skin (for which appropriate antifungal and antibacterial treatment was not carried out);
• the presence of hypersensitivity to the active ingredients of the drug or other excipients.

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Side effects Dermokasa

The use of Dermocas may cause symptoms at the treatment site, including burning with tingling, itching, irritation and hyperemia. Along with this, hypopigmentation with dryness, acne, erythema with telangiectasia, perioral dermatitis, hypertrichosis, follicular rash, hyperhidrosis and contact dermatitis of allergic genesis may be observed. Skin peeling of a focal or lamellar nature, cracking, compaction and maceration may cause skin atrophy and the appearance of secondary infections.

In addition, symptoms of intolerance are possible - Quincke's edema and anaphylactic symptoms.

Using the cream on large areas of the skin surface, especially over a long period of time, can cause the systemic effect of the drug. At the same time, any side effects that occur with the systemic use of GCS (this includes suppression of the adrenal cortex) can also develop with their local use.

Because the auxiliary elements of the drug are the components methylparaben (E 218) with propylparaben (E 216), patients may experience signs of allergy (they may be delayed), and sometimes – bronchial spasms.

Overdose

A single intoxication with gentamicin does not cause the development of signs of overdose.

Long-term use of the cream (or use in high doses) can cause suppression of pituitary-adrenal activity, which leads to secondary adrenal insufficiency, as well as the appearance of signs of hypercorticism.

Gentamicin poisoning may result in increased growth of antibiotic-resistant bacteria.

Skin irritation may also occur, which often resolves after discontinuing the medication. If a large amount of cream is accidentally swallowed, the stomach should be washed out.

Symptomatic measures are taken to eliminate the disorders. In case of chronic intoxication, gradual withdrawal of the drug is necessary. If increased growth of resistant microbes is observed, the drug should be discontinued and the required treatment should be administered.

Signs of hypercorticism in acute form can often be cured. If necessary, electrolyte balance is corrected. In case of chronic poisoning, Dermokas is gradually discontinued.

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Interactions with other drugs

Systemic use of miconazole leads to a slowdown in the activity of hemoprotein P450 CYP3A4/2C9, and in addition to this, to the suppression of metabolic processes of drugs, the metabolism of which is carried out with the participation of these enzymes.

Because the drug's systemic availability is limited, significant clinical interactions are rare. However, the drug should still be combined with orally administered anticoagulants (such as warfarin) with caution, and its anticoagulant effect should be monitored.

The combined use of miconazole and antidiabetic drugs (urea derivatives or phenytoin) may potentiate the properties of the latter.

It is prohibited to combine Dermocas with other topical medications.

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Storage conditions

Dermokas should be kept in a place out of reach of small children. The temperature should not exceed 25°C.

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Shelf life

Dermokas can be used for 2 years from the date of manufacture of the drug.

Application for children

There is no clinical data on the use of the drug in children. In this regard, it is recommended to refrain from prescribing it to this age group.

Because the proportions of weight and skin surface area in a child are greater than in an adult, the absorption of the cream is more active. Because of this, children have a higher tendency to suppress the activity of the HPA system when using GCS - as a result of the appearance of external symptoms of the action of corticosteroids.

Children treated with local GCS had problems with the adrenal glands - their function was suppressed. In addition, they had growth retardation, insufficient weight gain, increased intracranial pressure, and hypercorticism syndrome.

Symptoms of adrenal cortex suppression include low plasma cortisol levels and no response to adrenal stimulation tests using ACTH. Increased ICP values manifest as headaches, bulging fontanelles, and bilateral optic disc swelling.