Dermokas

Dermokas is an active corticosteroid, which is combined with other medicines.

Indications of the dermokas

It is used in the treatment of dermatoses, which can be eliminated with the help of SCS, as well as complicated (or suspected complications) secondary infection, provoked by bacteria that have sensitivity to the elements of drugs.

It is also used for fungal pathologies developing on the surface of the skin, and provoked by the activity of yeast fungi or dermatophytes (mycoses in the region of feet, lichen otriparous, epidermophytosis in the groin area and other cutaneous lesions having a fungal etiology).

Release form

The release occurs in the form of a cream, in tubes of 10 or 20 g. In a separate pack contains 1 tube.

[1], [2]

Pharmacodynamics

Gentamicin is an antibiotic with a wide range of drug activity, which is part of the aminoglycoside category. Has bactericidal effect, promotes highly effective local therapy for skin infections of a bacterial nature, having both primary and secondary form.

Demonstrates activity relative to:

• Gram-negative microbes - Pseudomonas aeruges, Aerobacter aerogenes, Escherichia coli, common proteus and Klebsiella pneumonia;
• Gram-positive microorganisms - streptococci (strains of α-, as well as β-hemolytic streptococcus from category A, sensitive to the action of the drug) and Staphylococcus aureus (coagulase-negative and-positive bacteria, and in addition individual strains producing penicillinase).

Miconazole has antimycotic properties - suppressing the processes of biosynthesis of ergostyrene, as well as changing the lipid structure of membranes, which causes fungal cells to die.

The substance exhibits an antimycotic effect against dermatophytes (red trichophyton, interdigital trichophyton, flaky epidermophyton and fluffy microsporium), fungi yeast and yeast-like (Candida albicans), and in addition to other pathogenic fungi (malassassia furfur, black aspergillus and Penicillium crustosum). In addition, it affects individual gram-positive microbes (streptococci with staphylococci).

The element betamethasone possesses antipruritic, anti-inflammatory, and in addition antiallergic and glucocorticoid properties. After local application of the drug, this component eliminates itching, has a vasoconstricting effect, reduces the volume of secretion of inflammation conductors (from the labrosites with eosinophils), IL-1 and IL-2, and γ-interferon (from macrophages with lymphocytes). Together with this, it slows the activity of the action of hyaluronidase and strengthens the strength of vascular membranes.

Interacts with specific endings within the cell cytoplasm, stimulates the process of RNA binding, causes the formation of proteins (including lipocortin), which mediate cellular responses. Lipocortin inhibits the activity of phospholipase A2, and at the same time blocks the ability of arachidonic acid to liberate, as well as the biosynthesis of PG, endoperoxides and leukotrienes, which lead to the development of inflammatory processes, allergy symptoms and other pathogens.

[3], [4], [5], [6], [7], [8]

Pharmacokinetics

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

[9], [10], [11], [12], [13], [14], [15], [16], [17]

Dosing and administration

Treat the affected area with a thin layer of medical cream. The procedure is performed twice a day (in the morning, and then at night). To get the desired effect, you must use Dermokas regularly. The duration of therapy is determined by the location and size of the pathogenic lesion, as well as the response of the patient to ongoing therapy.

[24]

Use of the dermokas during pregnancy

It is forbidden to prescribe Dermokas during lactation or pregnancy.

Contraindications

Among the contraindications:

• cutaneous tuberculosis, skin manifestations caused by vaccination, as well as the symptoms of syphilis that appeared on the skin;
• plaque form of psoriasis (common), perioral form of dermatitis, chicken pox and rosacea;
• varicosity;
• infectious diseases of a viral nature (among them HIV) and other infections of bacterial or fungal origin developing on the skin (in which the corresponding antimycotic and antibacterial treatment was not carried out);
• the presence of hypersensitivity to the active elements of the drug or other excipients.

[18], [19], [20], [21], [22], [23]

Side effects of the dermokas

Using Dermokas can lead to the appearance of symptoms on the treatment site, among which burning with stinging, itching, irritation and congestion. Along with this, hypopigmentation with dryness, acne, erythema with telangiectasias, perioral form of dermatitis, hypertrichosis, follicular rash, hyperhidrosis and a contact form of allergic dermatitis can be noted. Cutaneous scaling of the focal or lamellar nature, cracking, compaction and maceration can cause cutaneous atrophy and the appearance of secondary infections.

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

The use of the cream on large areas of the skin surface, especially over a long period of time, can cause the appearance of systemic effects of the drug. Along with this, any side-effects arising from the systemic use of GCS (this includes suppression of the adrenal cortex), can also develop with their local application.

Because the components of methylparaben (E 218) with propyl paraben (E 216) are auxiliary components of the drug, the patients may have signs of allergy (they may be delayed) and sometimes bronchial spasms.

Overdose

One-time intoxication with gentamycin does not cause signs of overdose.

Long-term use of the cream (or use in high dosages) can cause suppression of the pituitary-adrenal activity, on the background of which adrenal insufficiency of a secondary nature develops, and in addition the appearance of signs of hypercorticism.

When poisoning with gentamycin, an increased growth of antibiotic-resistant bacteria may occur.

May also be noted irritation on the skin, often disappearing after the drug is discontinued. If you unintentionally swallow a large amount of cream, you should wash your stomach.

Symptomatic measures are taken to correct the violations. Chronic intoxication requires a gradual withdrawal of the drug. If there is an increased growth of resistant microbes, the use of drugs should be abolished and the required treatment should be carried out.

Signs of hypercorticism in an acute form can often be cured. If necessary, the electrolyte balance is corrected. With chronic poisoning, Dermokas is gradually phased out.

[25], [26], [27], [28], [29]

Interactions with other drugs

Systemic use of miconazole leads to a slowdown in the activity of the hemoprotein P450 CYP3A4 / 2C9, and in addition to suppressing the metabolic processes of drugs metabolized by these enzymes.

Due to the fact that the system availability of the drug is limited, significant clinical interactions are rare. But the medication still needs to be carefully combined with internal anticoagulants (such as warfarin), and also to control its anticoagulant effect.

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

It is forbidden to combine Dermokas with other topical medicines.

[30]

Storage conditions

The dermo should be kept in a place that is closed from access by young children. In this case, the temperature should not exceed 25 ° C.

[31]

Shelf life

Dermokas is allowed to be used for 2 years from the date of release of the drug.

Application for children

No clinical information is available on the use of medication in children. In this regard, it is recommended to abandon his appointment to this age group.

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

Children who were treated with the help of local SCS, had problems with the work of the adrenal glands - there was a suppression of their function. In addition, they experienced growth retardation, insufficient weight gain, an increase in ICP and hypercorticoid syndrome.

Symptoms of suppression of the activity of the adrenal cortex: low cortisol indices inside the blood plasma, as well as the absence of any response to an adrenal stimulation test using ACTH substances. The increase in ICP values is manifested in the form of headaches, bloating of the fontanel, and in addition to this bilateral puffiness of the optic disc.