MLP A-2

MLP A-2 Uses, Dosage, Side Effects, Food Interaction and all others data.

Povidone-iodine is an iodophore with a powerful broad-spectrum germicidal activity against a wide range of bacteria, viruses, fungi, protozoa and spores. Microbicidal; oxidizes cell constituents; iodinates proteins and inactivates them.

Povidone iodine is a kind of iodine disinfectant which directly cause in vivo protein denaturation, precipitation of bacteria, and further resulting in the death of pathogenic microorganisms. Therefore, it is effective in disinfection and sterilization. It can kill viruses, bacteria, spores, fungi, and protozoa with low toxicity to human. Povidone-iodine aqueous solution has strong pharmacological activity against Staphylococcus aureus, Neisseria gonorrhoeae, Pseudomonas aeruginosa, syphilis, hepatitis B virus, HIV, and Trichomonas vaginalis.Povidone iodine gel is a gynecological topical semi-mobile colloidal agent made by povidone iodine and hydrophilic matrix. It is a system for maintaining its sustained release. Owing to the continuous release of free iodine, it can enable the skin and mucous membranes to maintain a certain effective concentration of iodine for killing bacteria. It is mainly used for gynecological vaginal infection. It exerted its effect through being miscible with vaginal secretions and further killing the inside pathogenic microorganisms, and thus blocking the spread of sexually transmitted diseases and invasion, as well as treating other infected vaginal diseases caused by other kinds of bacteria.

Published reports on the in vitro antimicrobial efficacy of iodophors demonstrate that iodophors are bactericidal, mycobactericidal, and virucidal but can require prolonged contact times to kill certain fungi and bacterial spores. Three brands of povidone-iodine solution have demonstrated more rapid kill (seconds to minutes) of S. aureus and M. chelonae at a 1:100 dilution than did the stock solution. The virucidal activity of 75–150 ppm available iodine was demonstrated against seven viruses. Other investigators have questioned the efficacy of iodophors against poliovirus in the presence of organic matter and rotavirus in distilled or tapwater. Manufacturers' data demonstrate that commercial iodophors are not sporicidal, but they are tuberculocidal, fungicidal, virucidal, and bactericidal at their recommended use-dilution.

MLP A-2
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	MLP A-2
Generic	Bupivacaine hydrochloride + lidocaine hydrochloride + triamcinolone acetonide + povidone-iodine
Type	Kit
Therapeutic Class
Manufacturer
Available Country	United States
Last Updated:	September 19, 2023 at 7:00 am

Uses

Bupivacaine is indicated for the production of local or regional anaesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures. The routes of administration and indicated Bupivacaine concentrations are: Local infiltration: 0.25% Peripheral nerve block: 0.25%, 0.5% Sympathetic block: 0.25% Lumbar epidural: 0.25%, 0.5% and 0.75% (non-obstetrical) Caudal: 0.25%, 0.5%

Abrasion, Bed sore, Burns, Cuts, Decubitus or stasis ulcers, Leg ulcers and pressure sores, Pre-operative and post-operative skin cleansing, Pre-operative scrubbing & washing, Pre-operative skin disinfection, Pressure sores, Skin infections, Vaginitis, Wound and burn dressing, Wound and ulcer cleansing, Wound cleansing, Wound infection, Wound sepsis, Wounds

MLP A-2 is also used to associated treatment for these conditions: Skin Infections, Skin disinfection, Irrigation of the ocular surface therapy, Prepping of the periocular region, Prophylaxis of bacterial skin infections

How MLP A-2 works

Povidone-iodine is called iodophore which means povidone acts as a carrier of iodine. Iodine is considered as the active moiety that mediates microbicidal actions. When released from the complex, free iodine (I2) penetrates the cell wall of microorganisms quickly, and the lethal effects are believed to result from disruption of protein and nucleic acid structure and synthesis. While the full mechanism of action is not fully elucidated, iodine is thought to inhibit vital bacterial cellular mechanisms and structures, and oxidizes nucleotides fatty or amino acids in bacterial cell membranes . Additionally, free iodine disrupts the function of the cytosolic enzymes involved in the respiratory chain, causing them to become denatured and deactivated . In vitro evidence suggests that iodine also counteracts inflammation elicited by both pathogens and the host response via multifactorial effects. In hosts, povidone-iodine was demonstrated to modulate the redox potential, inhibit the release of inflammatory mediators such as TNF-α and β-galactosidase, inhibit metalloproteinase production, and potentiate the healing signals from pro-inflammatory cytokines by activation of monocytes, T-lymphocytes, and macrophages, in vitro .

Dosage

MLP A-2 dosage

Each 30 ml contains 150 mg Bupivacaine Hydrochloride (anhydrous) USP.The dose of any local anaesthetic administered varies with the anaesthetic procedure, the area to be anaesthetized, the vascularity of the tissues, the number of neuronal segments to be blocked. In recommended doses, Bupivacaine produces complete sensory block, but the effect on motor function differs among the three concentrations.0.25% when used for caudal, epidural, or peripheral nerve block, produces incomplete motor block. Should be used for operations in which muscle relaxation is not important, or when another means of providing muscle relaxation is used concurrently. Onset of action may be slower than with the 0.5% or 0.75% solutions.0.5% provides motor blockade for caudal, epidural, or nerve block, but muscle relaxation may be inadequate for operations in which complete muscle relaxation is essential.Maximum dosage limit must be individualized in each case after evaluating the size and physical status of the patient, as well as the usual rate of systemic absorption from a particular injection site. Most experience to date is with single doses of Bupivacaine up to 175 mg. These doses may be repeated up to once every three hours. In clinical studies to date, total daily doses up to 400 mg have been reported. Until further experience is gained, this dose should not be exceeded in 24 hours.The following dosages have generally proved satisfactory and are recommended as a guide for use in the average adult. These dosages should be reduced for young, elderly or debilitated patients. Local Infiltration: 0.25%: up to max (mg) Epidural: 0.5%: 50-100 mg Epidural: 0.25%: 25-50 mg Caudal: 0.5%: 75-150 mg Caudal: 0.25%: 37.5-75 mg Peripheral Nerves: 0.5%: 25 mg to max. Peripheral Nerves: 0.25%: 12.5 mg to max. Sympathetic 0.25%: 50-125 mg

Pre-operative scrubbing & washing: Wet hands with water, then pour 5 ml of solution onto the palm and spread over both the hands, rub the scrub over the entire area for about 2 mintues, add water to develope copious suds, rinse throughly under running water.

Pre- and post-operative skin cleansing: After the skin is shaved and wet with water, apply surgical scrub & rub throughly for minimum 2 mintues, rinse of with the sterile gauze saturated with water.

Side Effects

Central Nervous System and Neurological: Restlessness, excitement, nervousness, dizziness, tinnitus, blurred vision, miosis, nausea, vomiting, numbness of the tongue and perioral region, chills, tremors, muscle twitching, convulsions. Cardiovascular System Reactions: Myocardial depression and peripheral vasodilatation resulting hypotension and bradycardia, ventricular arrhythmia, cardiac arrest. Hypersensitivity: urticaria, pruritus, erythema, angioneurotic edema ,tachycardia, sneezing, nausea, vomiting, dizziness, syncope, excessive sweating, elevated temperature, and possibly, anaphylactoid reactions.

Local skin irritation and sensitivity. Application to large areas of denuded skin may produce systemic effects due to iodine absorption.The application of povidone iodine to large wounds or severe burns may producesystemic adverse effectssuch as metabolic acidosis, hypernatraemia and impairment of renal function.

Toxicity

ORAL (LD50): Acute: 8000 mg/kg [Rat]. 8100 mg/kg [Mouse]

Precaution

Local anaesthetics should only be employed by clinicians who are well versed in diagnosis and management of dose-related toxicity and other acute emergencies which might arise from the block to be employed, and then only after ensuring the immediate availability of oxygen, other resuscitative drugs, cardiopulmonary resuscitative equipment, and the personal resources needed for proper management of toxic reactions and related emergencies.Should be given cautiously to the elderly, the debilitated and to children, to patients with epilepsy, impaired cardiac conductions, shock, liver damage and myasthenia gravis.The lowest dosage of local anaesthetic that results in effective anaesthesia should be used to avoid high plasma levels and serious adverse effects. The rapid injection of a large volume of local anaesthetic solution should be avoided and fractional (incremental) doses should be used when feasible. Careful and constant monitoring of cardiovascular and respiratory (adequacy of ventilation) vital signs and the patient's state of consciousness should be performed after each local anaesthetic injection. Because of the risk of systemic adverse effects when local anaesthetics are absorbed too rapidly, they should not be injected into inflamed or infected tissues and should not be applied to damaged mucosa.

Avoid contact with eyes; should not be used under occlusive dressing. Pregnancy, lactation

Interaction

Bupivacaine should be used with caution in patients receiving other local anaesthetics or agents structurally related to amide‐type local anaesthetics, e.g. certain anti‐arrhythmics, such as lidocaine and mexiletine, since the systemic toxic effects are additive.Specific interaction studies with Bupivacaine and anti arrhythmic drugs class III (e.g. amiodarone) have not been performed, but caution should be advised.

Volume of Distribution

Povidone-Iodine is intended for topical application and has no volume of distribution.

Elimination Route

Povidone-Iodine is intended for topical application and is not absorbed.

Half Life

Povidone-Iodine is intended for topical application and is not eliminated.

Clearance

Povidone-Iodine is intended for topical application and is not eliminated.

Elimination Route

Povidone-Iodine is intended for topical application and is not eliminated.

Pregnancy & Breastfeeding use

Bupivacaine injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution should be exercised when administered during lactation.

Pregnancy Category D. There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Contraindication

Hypersensitivity to Bupivacaine, other amide type local anaesthetics or other components of these preparations; Intravenous regional anaesthesia; obstetrical paracervical block anaesthesia.

Hypersensitivity; prolonged use in patients with thyroid disorders or on lithium therapy. Special caution is needed when regular applications to broken skin are made to patients with pre-existing renal insufficiency. Regular use should be avoided in patients on concurrent lithium therapy.