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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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Jublia (efinaconazole) OTC - Uses, Dose, Side effects, MOA, Brands

Jublia (efinaconazole) is an antifungal drug that is used to treat fungal infections of the toe nails.

Jublia (efinaconazole) Uses:

Onychomycosis:
- It is indicated for the topical management of toenail onychomycosis brought on by:
  Rubrum Trichophyton
  Mentagrophytes of Trichophyton

Dose in Adults

Jublia (efinaconazole) Dose in the treatment of Onychomycosis:

For 48 weeks, it is placed topically over the affected toenails once every day.

Use in children:

Not indicated

Pregnancy Risk Factor C

SubQ administration of the drug led to adverse outcomes in fetal reproduction studies on animals.
Topical application may result in minimal systemic absorption.

Efinaconazole use during breastfeeding:

It is unknown if the drug will be excreted into breast milk.
The manufacturer suggests that nursing mothers use it with caution, even though there may be some systemic absorption.

Jublia (efinaconazole) Dose in Kidney disease:

The manufacturer has not provided any recommendations regarding dose adjustment in patients with kidney disease.

Jublia (efinaconazole) Dose in Liver disease:

The manufacturer has not provided any recommendations regarding dose adjustments in patients with liver disease.

Side Effects of Jublia (efinaconazole):

Dermatologic:
- Ingrown nail
Local:
- Application site vesicles
- Application site dermatitis
- Application site pain

Contraindication to Efinaconazole Include:

There are no contraindications for its use, according to the manufacturer. Canadian labeling:

People who are allergic to any of the components or drugs should not use them.

Warnings and precautions

Local irritation
- Local skin irritation, pain, or dermatitis may occur.
- Patients should seek professional advice if they continue to experience skin reactions.

Monitoring parameters:

None is mentioned in the manufacturer's labeling. Monitor the response to treatment.

How to administer Jublia (efinaconazole)?

It is applied as a topical 10% solution over the affected toenails.
Before applying the solution, the toenails should be clean and dry.
After taking a shower or washing the toenails, wait for at least ten minutes before applying the solution.
Hold the bottle directly over the affected toenail after removing the bottle cap.
Apply one drop over the affected toenail by squeezing the bottle. Two drops may be applied if the big toe is affected.
Using the attached applicator brush, gently spread the solution completely and thoroughly around the toenail.
Cover the nailbed, nail folds, hyponychium, and the undersurface of the toenail.
After proper application, let it dry and wash hands with soap and water.
While using the treatment, stay away from pedicures, cosmetic nail products, and nail polish.

Mechanism of action :

It is an antifungal medication from the "azoles" class that kills fungi by preventing the enzyme lanosterol14alpha-demethylase from functioning.
This enzyme is responsible for the biosynthesis ergosterol, which is a component of fungal cell membranes.

Half-life elimination: