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Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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Calcipotriene (Calcipotriol) - For Plaque Psoriasis

Calcipotriene is a synthetic vitamin D analogue that prevents the proliferation and keratinization of skin cells. It is applied topically to treat plaque psoriasis of the scalp or body (by using a cream, foam, or ointment) (applying the solution or foam)

Calcipotriene Dose in Adults

For Topical Use in the treatment of Plaque psoriasis:

Cream:
- Twice daily, apply a thin layer to the afflicted area of the skin.
Foam:
- Twice daily, apply a thin coating to the skin or scalp that is troubled.
Ointment:
- Once or twice each day, apply a thin coating to the afflicted area of the skin.
Solution:
- Apply to the affected scalp twice a day.

Calcipotriene Dose in Children

Calcipotriene is effective and safe for use in children with psoriasis. It is second only to corticosteroids as a topical medicine to treat psoriasis in children. Doses in children and adults are almost the same.

Pregnancy Risk Factor C

Animal studies have shown adverse effects on the foetus.
Pregnancy should not be limited to calcipotriene.

Calcipotriene use during breastfeeding:

The effects of the drug on nursing children are unknown.
However, it is recommended to avoid using the nipple for topical purposes.

Calcipotriene Dose in Renal Disease:

The manufacturer has not recommended any adjustment in the dose in patients with Renal disease.

Calcipotriene Dose in Liver Disease:

The manufacturer has not recommended any adjustment in the dose in patients with liver disease.

The frequency may vary with the site of application.

Common Side Effects of Calcipotriene Include:

Dermatologic:
- Skin rash
- Dermatitis
- Burning sensation of the skin
- Stinging of the skin
- Desquamation
- Pruritus
- Skin irritation
- Erythema
- Exacerbation of psoriasis
- Xeroderma
Central nervous system:
- Tingling of skin
Local:
- Application site pain
- Application site erythema

Contraindication to calcipotriene include:

Animal studies have shown adverse effects on the foetus.
Pregnancy should not be limited to calcipotriene.

Calcipotriene use during breastfeeding:

The effects of the drug on nursing children are unknown.
However, it is recommended to avoid using the nipple for topical purposes.
- Allergy reactions to calcipotriene and any component of the formulation
- Patients suffering from vitamin D toxicity or hypercalcemia
- Apply to the skin as a cream or ointment.
- Patients suffering from acute psoriatic eruptions

Warnings and Precautions

Contact dermatitis:
- It is possible to get allergic contact dermatitis.
Hypercalcemia:
- It is possible for serum calcium to rise in a transient, but reversible manner.
- If hypercalcemia is detected, treatment must be stopped until serum levels return to normal.
Irritation
- Patients may experience temporary irritation due to the lesions or the normal skin around them. This may cause therapy to be stopped.

Calcipotriol (calcipotriene): Drug Interaction

Risk Factor C (Monitor therapy)
Calcium Salts	Enhances the hazardous or harmful effects of vitamin D analogues.
Cardiac Glycosides	Cardiac Glycosides' arrhythmogenic impact may be increased by vitamin D analogues.
Thiazide and Thiazide-Like Diuretics	Could make vitamin D analogues' hypercalcemic impact stronger.
Risk Factor X (Avoid combination)
Aluminum Hydroxide	Aluminum Hydroxide levels in the blood may rise while using vitamin D analogues. In particular, there may be an increase in aluminium absorption, which would raise serum aluminium contents.
Multivitamins/Fluoride (with ADE)	Enhances the hazardous or harmful effects of vitamin D analogues.
Multivitamins/Minerals (with ADEK, Folate, Iron)	Enhances the hazardous or harmful effects of vitamin D analogues.
Sucralfate	The serum concentration of sucralfate may rise in response to vitamin D analogues. In particular, there may be an increase in serum aluminium content as a result of enhanced aluminium absorption from sucralfate.
Vitamin D Analogs	Possibly intensifying the hazardous or harmful effects of other vitamin D analogues.

Monitoring Parameters:

Serum calcium levels and response to therapy.

How to administer calcipotriene?

It must only be used topically, and contact with the face and eyes must be avoided.
If contact occurs with the eyes, give them a vigorous water rinse.

Calcipotriene Cream, foam, and ointment:

Apply the solution and thoroughly and gently massage the afflicted region.
After usage, wash your hands in warm, soapy water.

Calcipotriene Foam and solution:

Before using, comb the hair to eliminate any debris.
To the sores on the scalp, apply the solution.
Completely and gently rub.
After using, wash your hands with soap and water.
Apply the foam after drying your hair.

Mechanism of action of Calcipotriene:

It is a synthetic counterpart of vitamin D. It binds to receptors for vitamin D.
It inhibits the proliferation and differentiation of keratinocytes. This regulates skin cell proliferation.
The symptoms will improve within two weeks.
A marked improvement can take up to eight weeks.

AbsorptionAfter topical application of Cream or foam, the percentage is approximately 6% to 1% respectively after ointment use and solution use. Calcipotriene after absorption is metabolized to inactive metabolites.

Calcipotriene International Brands: