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Quadruple is a generic for Panalog. This ointment is an otic and topical medication that contains Nystatin-Neomicin Sulfate-Thiostrepton -Triamcinolone Acetonide and is for use in cats and dogs only.
Each ml. contains; | |
---|---|
Nystatin | 100,000 units |
Neomycin Sulfate(equivalent to neomycin base) | 2.5mg |
Thiostrepton | 2,500 units |
Triamcinolone Acetonide | 1mg |
In a polyethylene and mineral gel base |
Frequency of administration is dependent on the severity of the condition. For mild inflammations, application may range from once daily to once a week; for severe conditions nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment may be applied as often as two to three times daily, if necessary. Frequency of treatment may be decreased as improvement occurs.
Wear gloves during the administration of the ointment or wash hands immediately after application.
Before instilling any medication into the ear, examine the external ear canal thoroughly to be certain the tympanic membrane is not ruptured in order to avoid the possibility of transmitting infection to the middle ear as well as damaging the cochlea or vestibular apparatus from prolonged contact. If hearing or vestibular dysfunction is noted during the course of treatment, discontinue the use of nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment.
Clinical and experimental data have demonstrated that corticosteroids administered orally or by injection to animals may induce the first stage of parturition if used during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis.
Additionally, corticosteroids administered to dogs, rabbits and rodents during pregnancy have resulted in cleft palate in the offspring. In dogs, other congenital anomalies have resulted; deformed forelegs, phocomelia, and anasarca.
Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment is not intended for the treatment of deep abscesses or deep-seated infections such as inflammation of the lymphatic vessels. Parenteral antibiotic therapy is indicated in these infections. Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment has been extremely well tolerated. Cutaneous reactions attributable to its use have been extremely rare. The occurrence of systemic reactions is rarely a problem with topical administration.
There is some evidence that corticosteroids can be absorbed after topical application and cause systemic effects. Therefore, an animal receiving nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment therapy should be observed closely for signs such as polydipsia, polyuria, and increased weight gain. Nystatin, neomycin sulfate, thiostrepton and triamcinolone acetonide ointment is not generally recommended for the treatment of deep or puncture wounds or serious burns.
Sensitivity to neomycin may occur. If redness, irritation or swelling persists or increases, discontinue use. Do not use if pus is present since the drug may allow the infection to spread. Keep this and all medications out of the reach of children.
Avoid ingestion. Oral or parenteral use of corticosteroids (depending on dose, duration of use, and specific steroid) may result in inhibition of endogenous steroid production following drug withdrawal.
SAP and SGPT (ALT) enzyme elevations, polydipsia/polyuria, vomiting, and diarrhea (occasionally bloody) have been observed following parenteral or systemic use of synthetic corticosteroids in dogs.
Cushing's syndrome has been reported in association with prolonged or repeated steriod therapy in dogs.
Temporary hearing loss has been reported in conjunction with treatment of otitis with products containing corticosteroids. However, regression usually occurred following withdrawal of the drug. If hearing dysfunction is noted during the course of treatment with nystatin, neomycin sulfate,
240 mL bottle: Do not store above 86°F. 7.5 mL, 15 mL, 30 mL tubers: Store at room temperature; avoid excessive heat (104°F).
Quadruple is:
Quadruple ointment contains four active ingredients that are antibacterial, antipruritic, antifungal, and anti-inflammatory. When applied topically, relief can be prolonged due to a synthetic corticosteroid known as triamcinolone acetonide. Healing then can come to lesions along with reduction in edema and inflammation and subsiding of pruritus.
For treating cutaneous infections from Candida albicans (also known as monilia), Nystatin is the first antibiotic antifungal that is effective and tolerated well by animals. In vitro, Nystatin is shown to be fungistatic when used for yeast-like and yeast fungi as well as fungi shown to be pathogenic with animals. When used for bacteria, this activity was not shown.
For gram-positive organisms, Thiostrepton has been shown to be effective. This includes antibiotic resistant organisms, gram-negative and gram-positive, and other antimicrobial actions. Combined, these treatments can assist in the treatment of bacterial infection that is superficial to prevent the organisms that are responsible.
The systemic or parenteral use of synthetic corticosteroids may cause dogs to exhibit symptoms like:
Repeated or prolonged steroid use may lead to Cushing’s syndrome in dogs. Corticosteroid use may cause hearing loss that is temporary when used to also treat otitis. After withdrawing from this drug, symptoms will typically regress. Discontinue the use of Quadruple Ointment if you notice hearing dysfunction during treatment.
Do not use Quadruple Ointment to treat deep-seated infections, including lymphatic vessel inflammation or significant abscesses. Those infections require parenteral antibiotic therapy. This medication (also known as nystatin-neomycin sulfate-thiostrepton-triamcinolone acetonide ointment) is shown to be well-tolerated. In rare cases, there have been cutaneous reactions to this medication. When administered topically, a systematic reaction rarely occurs.
Following topical application, some systematic effects may be observed from the absorption of corticosteroids. Animals using Quadruple Ointment require close observation for symptoms including:
It is not recommended to use Quadruple Ointment for puncture or deep wounds or serious burns. Animals taking this medication may develop a neomycin sensitivity. Discontinue Quadruple Ointment if your pet experiences persistent or ongoing swelling, redness, or irritation. Infection may spread is pus is present in the wound during application.
Always keep this and all medication out of children’s reach. Do not ingest this medication. Depending on the steroid type, length of use, and dosage, parenteral or oral corticosteroid use could lead to a decrease in endogenous steroid production after the animal withdraws from the medication.