Ointment administration

Ointments may be preferred in patients undergoing macular hole surgery with postoperative face-down positioning. Ointment administration... 

Panthenol is frequently used in ointments and solutions for the treatment of burns, anal fissures, and inflammation of the conjunctiva. The vitamin has to be substituted in patients on total parenteral nutrition and in those who regularly undergo dialysis. Hypervitamin-osis has not been observed for doses up to 5 g/d (22). Furthermore, the administration of pantothenic acid leads to improved surgical wound healing due to its antiinflammatory properties. 

Eye preparations—These are specifically intended for administration to the eye in the form of solutions, lotions, or ointments. All preparations must be sterile. 

Oxytetracycline preparations for oral administration should contain not less than 90% or not more than 120% [i] or not less than 90% and not more than 110% [2], of the labeled amount. For ointment, the requirements are not less than 90.0% and not more than 115% (for oxytetracycline HC1 and Hydrocortisone ointment, or 120% for other ointment. For ophthalmic suspension mixture with hydrocortisone acetate, its content should contain not less than 90% and not more than 110% [1]. 

Treatment—Patients should be decontaminated immediately prior to treatment using the decontamination method presented in Section 7.3.2. British Anti-Lewisite (BAL) dimercaprol antidote will alleviate some effects. It is available as a solution in oil for intramuscular administration to counteract systemic effects. It is not manufactured currently in the forms of skin and eye ointments.2... 

The provision of optimal drug action from topical administration sites (such as ointments, creams, transdermal patches, ophthalmic, ear, and nasal preparations)... 

Aciclovir is an antiviral indicated in the treatment and prophylaxis of cold sores. It is available for systemic administration (tablets) or topical use (cream, eye ointment). In the management of cold sores, the cream is applied every 4 hours and continued for 5 days. Its use should be started as soon as symptoms (tingling sensation) begin. 

Rectal Avoids problems of stability in gastrointestinal tract No first-pass metabolism Useful if oral administration is not possible Unpopular Inconvenient Erratic absorption Irritation Suppositories, enemas (solutions, suspensions, emulsions), foams, ointments, creams... 

Nitroglycerin, the prototype of the nitrates is characterized by a rapid onset and short duration of action. It is usually administered sublingually (via the oro-mucosal route), which allows a rapid and efficient absorption and avoids the strong first pass effect after oral administration. Nitroglycerin is available as tablets, capsules (for sublingual administration) but also as transdermal preparations, sprays, and ointments. 

Only solutions of lipophilic antibiotics are able to cross the external barrier of the cornea (drops) and the internal blood-retina barrier (systemic administration) to yield sufficient concentrations in the internal eye (vitreous). Keratitis and ulceration of the cornea can be treated by frequent administration of highly concentrated (fortified) antibiotic drops. In endophtalmitis, emergency vitreous aspirate and in-travitreal and subconjunctival injection of antibiotic solutions with a long half-life is the cornerstone of treatment. These solutions should be prepared by the hospital pharmacy. Empiric topical treatment of minor external eye infections consists of antibiotic containing gels or ointments. 

Multiply resistant coagulase-negative staphylococci are frequently the cause of postoperative endophtalmitis and require the use of a glycopep-tide (e.g. vancomycin). For topical treatment fusidic acid eye gel, tetracycline or chloramphenicol ointment are available, and can be administered 2 t.d. for 7 days. Trachoma should be treated with an oral macrolide (e.g. a single oral dose of 20 mg/kg azithromycin) or doxycyclin for 3 weeks (for moderate to severe cases). Keratitis needs hourly administration of fortified antibiotic eye drops for 2 weeks. Endophtalmitis needs specialist treatment for 6 weeks. 

Ophth ointments may cause temporary blurring of vision following administration... 

Topical administration It is employed for local action in the form of ointments, creams, jellies etc. for its antiseptic and local anaesthetic action. The lipid soluble drugs penetrate the skin easily and rapidly. 

Topical administration in the form of drop and ointment have been used for the treatment of infected burns, wounds and the prevention of intravenous catheter infections and in the treatment of ocular infections. 

Nystatin is a polyene macrolide much like amphotericin B. It is too toxic for parenteral administration and is only used topically. Nystatin is currently available in creams, ointments, suppositories, and other forms for application to skin and mucous membranes. It is not absorbed to a significant degree from skin, mucous membranes, or the gastrointestinal tract. As a result, nystatin has little toxicity, although oral use is often limited by the unpleasant taste. 

Polymyxin B and colistin (polymyxin E) (Fig. 3.9) are the least toxic of the five polymyxin antibiotics designated alphabetically A-E. Both polymyxin B and colistin are complex polypeptide compounds with specialized activity against gram-negative organisms but they are both nephrotoxic. Topical application and oral administration are more commonly used routes. Polymyxin B is used widely in ointments for topical applications and may be effective in case of mastitis, but it seldom is administered parenterally because of the possibility of renal toxicity. 

Nystatin is available as an ointment for topical applications and as a suspension or tablet for oral administration. It is approved for oral administration at 100,000 lU/day for 7 days in chickens and turkeys by the Food and Drug Administration (FDA), but it is also used in cattle for treatment of genital mycoses. Nystatin is remarkably low in toxicity when given orally, but it is much more toxic after parenteral administration. 

For liquid (e.g., solution, suspension, elixir) and semisolid (e.g., creams, ointments) dosage forms, a change to or in polymeric materials (e.g., plastic, rubber) of primary packaging components, when the composition of the component as changed has never been used in a CDER-approved product of the same dosage form and same route of administration. For example, a polymeric material that has been used in a CDER-approved topical ointment would not be considered CDER-ap-proved for use with an ophthalmic oinhnent. 

The influence of these preparations on healing processes in wounds on subcutaneous, peroral or local administration as 5-10% ointments (Table 14) has been examined. 

Ethoxysilatrane proved to be effective in treating wounds also via other routes of administration. Thus, in the second series of tests involving 40 rabbits with skin-muscle wounds of 300 mm2 size 1-ethoxysilatrane was administered both subcutaneously and per os at 50 mg/kg doses and as 5% ointment in a 1 1 vaseline-lanolin base. 

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