Betamethasone + Neomycin Sulphate (E/E)
Indications
Eye: Inflammatory
conditions (eg. uveitis, marginal keratitis, allergic conjunctivitis,
blepharitis and episcleritis) where development of bacterial infection
is likely.
Ear: Otitis externa and other inflammatory conditions where bacterial infection is present or suspected.
Nose: Inflammatory conditions where infection is present or suspected.
Ear: Otitis externa and other inflammatory conditions where bacterial infection is present or suspected.
Nose: Inflammatory conditions where infection is present or suspected.
Pharmacology
Betamethasone is a
corticosteroid which is effective in inflammatory dermatoses. It is also
effective in less responsive conditions such as psoriasis.
Betamethasone has a 16β-methyl group that enhances the
anti-inflammatory action of the molecule and reduces the sodium and
water retaining properties of the fluorine atom bound at carbon 9.
Neomycin sulfate is bactericidal against many bacteria which are commonly associated with skin infections. Neomycin is a broad spectrum antibiotic which actively transported across the bacterial cell membrane, binds to a specific receptor protein on the 30s subunit of bacterial ribosomes, and interferes with an initiation complex between mRNA (messenger RNA) and the 30s subunit, inhibiting protein synthesis. DNA may be misread, thus producing nonfunctional proteins; polyribosomes are split apart and are unable to synthesize protein.
Neomycin sulfate is bactericidal against many bacteria which are commonly associated with skin infections. Neomycin is a broad spectrum antibiotic which actively transported across the bacterial cell membrane, binds to a specific receptor protein on the 30s subunit of bacterial ribosomes, and interferes with an initiation complex between mRNA (messenger RNA) and the 30s subunit, inhibiting protein synthesis. DNA may be misread, thus producing nonfunctional proteins; polyribosomes are split apart and are unable to synthesize protein.
Dosage & Administration
Drops:
- Eye: 1 drop instilled into the eye every one or two hours until control is achieved, when the frequency may be reduced.
- Ear: 2 or 3 drops instilled into the ear, every two or three hours until control is achieved, when the frequency can be reduced.
- Nose: 2 or 3 drops instilled into each nostril two or three times daily.
Contraindications
Viral, fungal, tuberculous or purulent
conditions. Use in the eye is contra-indicated if glaucoma is present or
where herpetic keratitis (e.g. dendritic ulcer) is considered a
possibility. Inadvertent use of topical steroids in the latter condition
can lead to extension of the ulcer and marked visual deterioration.
Preparations containing neomycin should not be used for treating otitis
externa when the ear drum is perforated, because of the risk of
ototoxicity.
Side Effects
Acute sensitization to neomycin is a rare
event but can occur after topical application to the eye. Eye drops
containing corticosteroids cause a serious rise in intra-ocular pressure
in a small percentage of the population, including most of those with a
family history of glaucoma. A milder rise may be experienced by a
larger proportion of subjects if treatment is continued for longer than a
few weeks. Thinning of the cornea leading to perforation has occurred
with use of topical corticosteroids. Cataract is reported to have
occurred after unduly prolonged treatment of eye conditions with topical
corticosteroids.
Pregnancy & Lactation
Pregnancy Category-Not Classified. FDA has
not yet classified the drug into a specified pregnancy category. Topical
administration of corticosteroid to pregnant animals can cause
abnormalities of fetal development. The relevance of this finding to
human beings has not been established; however, topical steroids should
not be used extensively in pregnancy, i.e. in large amounts or for
prolonged periods.
Precautions & Warnings
Steroids should not be administered to "red
eyes" until a definitive diagnosis has been made. Ophthalmological
treatment with steroid preparations should not be repeated or prolonged
without regular review to exclude raised intra-ocular pressure or
unsuspected infections. The unnecessary topical use of neomycin
containing products should be avoided in order to minimize the
occurrence of neomycin-resistant organisms (and organism cross-resistant
to other aminoglycosides).
Therapeutic Class
Ophthalmic steroid - antibiotic combined preparations
Storage Conditions
Store below 25° C
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