Genodex

Genodex is a complex GCS drug with antimicrobial effect.

Indications Genodex

It is used to treat eye pathologies:

• blepharitis of allergic or infectious origin;
• anterior uveitis, conjunctivitis or keratitis;
• ulcers in the corneal area that are bacterial in nature;
• barley, scleritis or dacryocystitis;
• eye lesions caused by chlamydia;
• iritis, episcleritis or iridocyclitis;
• sympathetic uveitis;
• neuritis affecting the optic nerve;
• inflammation that develops as a result of injury in the eye area;
• prevention of the development of complications of an infectious nature after surgical procedures, as well as interventions to remove foreign objects.

It is also used in the treatment of ear diseases:

• otitis externa;
• localized form of neurodermatitis;
• dermatitis of a seborrheic nature;
• eczema;
• prevention of the occurrence of complications of infectious genesis after surgical procedures.

Release form

The medicine is released in ear or eye drops. The medicine is contained in glass bottles with a capacity of 5 ml; inside the pack there is 1 such bottle equipped with a dropper.

Pharmacodynamics

Genodex has an anti-inflammatory effect, which is provided by the activity of dexamethasone, as well as an antibacterial effect, due to the action of antibiotics such as polymyxin B and chloramphenicol.

Polymyxin B is a polypeptide antibiotic whose action is based on the ability to be synthesized with phospholipids inside the cell walls of bacteria, and in addition to this, to destroy the function of the respiratory chain enzymes of sensitive microbes and the ionic permeability of the walls, which leads to the loss of potassium ions by bacterial cells.

It demonstrates activity against many gram-negative microbes. It has a bactericidal effect against dysentery, as well as Escherichia coli, Pseudomonas aeruginosa, typhoid bacillus, and paratyphoid bacillus.

Chloramphenicol has a wide range of therapeutic effects. The antimicrobial effect develops by slowing down the processes of protein binding inside the ribosomes of sensitive microbes. It has a bacteriostatic effect, and when used in high doses, a bactericidal effect.

The element affects both gram-negative and -positive microbes, and also rickettsia with mycoplasma, as well as chlamydia. In addition, it affects the activity of bacterial strains resistant to streptomycin, penicillin and sulfonamides. Fungi and Pseudomonas aeruginosa are resistant to chloramphenicol. Some types of microbes slowly develop moderate resistance, which is only cross-resistant in isolated cases.

Dexamethasone is an artificial GCS with anti-inflammatory, immunosuppressive and anti-allergic properties. The substance stabilizes the walls of leukocyte lysosomes.

The component helps to bind and release lipomodulin, which inhibits the activity of phospholipase A2, slows down the formation of arachidonic acid breakdown products, reduces the number of lymphocytes with monocytes moving to the inflammation site, and also prevents the release of inflammatory mediators from labrocytes and eosinophils. At the same time, it strengthens capillary strength and reduces exudation, normalizes the process of cytokine release (IL-1 and IL-2, as well as γ-interferon from monocytes with lymphocytes) and induces involution in the lymph tissue area. Suppresses the activity of proteases and hyaluronidase.

Dexamethasone interacts with specific protein endings of target tissues, promotes the regulation of expression of relevant genes, and affects protein binding.

The substance stimulates protein catabolism processes and induces the activity of enzymes responsible for amino acid metabolism. The drug weakens binding, enhances protein breakdown within lymph tissue, muscles, connective tissue and epidermis. In addition, it helps restore the sensitivity of adrenoreceptors to catecholamines.

Pharmacokinetics

Polymyxin B is not absorbed through mucous membranes and epidermis, but can be absorbed in case of local administration of the substance into the eye when there is tissue damage.

After topical application, chloramphenicol passes through the cornea at high speed (even if there is no inflammation). High solubility rates within lipids with water allow the required medicinal values to be quickly achieved within the tissue eye fluid.

GCS are absorbed through the iris, cornea, ocular fluid, retina with choroid and ciliated epithelium. Dexamethasone instilled into the conjunctival sac passes into the conjunctiva and corneal epithelium without complications. Medicinal concentrations are noted inside the aqueous ocular environment. If the eye tissues are inflamed or there is damage to the cornea/mucous membrane, the absorption rate of the element increases significantly. When using drops in the required medicinal portions, systemic effects do not develop.

The duration of the anti-inflammatory effect of the drug when instilling 1 drop of a 0.1% substance into the eye is 4-8 hours. Approximately 60-70% of dexamethasone entering the circulatory system is synthesized with blood plasma protein. The metabolism of this element occurs in the liver with the participation of hemoprotein enzymes CYP2C; excretion of metabolic products occurs mainly with feces. The half-life is usually 3 hours.

Dosing and administration

Genodex demonstrates higher efficiency when used in the treatment of acute forms of pathologies, rather than chronic ones.

During eye pathologies, it is necessary to instill 1-2 drops of the medicine into the conjunctival sac every hour during the day, and then at night, at intervals of 2 hours, at the initial stage of therapy. If the medicine has a positive effect, the dosage is reduced to 1 drop with intervals between procedures of 4 hours. Then the dose is reduced to 1 drop 3-4 times a day - this scheme should be optimal for monitoring the patient's condition.

Therapy for ear diseases: first, you need to thoroughly clean the area of the external auditory canal. At first, you need to instill 3-4 drops of the medicine 2-3 times a day. After obtaining the desired result, the dosage is gradually reduced, reaching the point of discontinuing the drug. The duration of such therapy may vary depending on the type of disorder and the drug's medicinal effectiveness; it should be selected by a doctor, individually for each patient (minimum - several days, maximum - several weeks).

[ 2 ]

Use Genodex during pregnancy

The medication should not be prescribed to breastfeeding mothers or pregnant women.

Contraindications

Main contraindications:

• tuberculosis in the ear or eye area, which is of an infectious nature;
• common lichen;
• chickenpox;
• early stage of herpes simplex in acute form;
• diseases in the eyelid and conjunctiva area that are purulent or viral in nature;
• pathologies affecting the cornea and accompanied by epithelial defects;
• trachoma or glaucoma;
• suspicion of the presence of an infection of fungal origin;
• ruptured eardrum;
• the presence of intolerance to the components of the drug.

Side effects Genodex

The use of drops may cause the appearance of certain side effects:

• increase in IOP indicators;
• glaucoma, which is characterized by damage affecting the optic nerve;
• decreased visual acuity and narrowing of the visual field;
• photosensitivity;
• the appearance of a subcapsular form of posterior cataract;
• an infection affecting the eyes that is secondary in nature and caused by the activity of pathogenic agents, including herpes simplex, isolated from the eye tissue;
• rupture in the area of the eyeball.

If the cornea becomes thinner, there is a risk of rupture. With prolonged use of drops, cataracts appear.

Occasionally, filtering pemphigus has been reported with local steroid use after cataract surgery. Steroid use may also exacerbate corneal infections of fungal or viral origin. Sometimes a burning or tingling sensation may occur.

When the substance is instilled into the ear, itching may occur, and sometimes tinnitus or dizziness.

[ 1 ]

Interactions with other drugs

Combining Genodex with streptomycin or monomycin is prohibited, as this may lead to potentiation of ototoxicity.

The drug cannot be combined with erythromycin, because it is an antagonist of the chloramphenicol component.

[ 3 ], [ 4 ]

Storage conditions

Genodex must be stored in a dark and dry place, out of the reach of children. Temperature values should not exceed 25°C.

Shelf life

Genodex can be used within 18 months from the date of release of the therapeutic agent. The shelf life of the solution from an already opened bottle is 30 days.

Application for children

Genodex is not used to treat children under 3 years of age.

Analogues

Analogues of the drug are Garazon, Pledrex, Dexa with Sofradex and Combinil Duo.