Tacrolimus ointment for atopic dermatitis let us discuss Tacrolimus. What is this drug? Tacrolimus. Here we can identify one of the suffix IMAS.
So drugs ending with suffix IMAS are commonly known as immunosuppressants. So tacrolimus is an immunosuppressant. This drug targets the T cell activity. So T cell proliferation is going to be inhibited by this drug, which results in the immunosuppression. That’s why Tacrolimus can be used by topical purpose as an immunosuppressant for the treatment of atopic dermatitis.
This is a skin disorder with enhanced immune activity. Such immune based skin reactions can be controlled by Tacrolimus. This drug can also be used by systemic root as an immunosuppressant during organ transplantation. But today in this , we are going to see how this drug is useful by topical root as ointment. And this drug can be used even in the children with a’s greater than two years.
So Tacrolamus ointment is available both for pediatric purpose as well as adults. But in the children with a’s less than two years, this drug should not be used. So first of all, let us see how this Tachylemus acts on the T cell. T cell receptors are present, which are activated when antigen component interacts with these receptors. So, antigens can stimulate the T cell activity.
Tacrolimus ointment for atopic dermatitis
When they bind to T cell receptor, they can activate the ion channel calcium channel. Now, calcium can enter into the T cells, which activates the T cell proliferation. One of the target for this calcium is the calcium urine. Now, calcium can bind to this calcium urine, forming a calcium calcium urine complex, which is then activated. And then it targets NF 80 nuclear factor of activated T cells.
Now, the activated NFA T can then target the DNA within the nucleus, so it can interact with the DNA such that it can produce a gene transcription and protein synthesis. And one of the protein that is going to be formed is the Il Two, which is released from the T cells. Now, this Il two can act on the Il two receptors, which increase the T cell amplification. So immune response is further increased by release of Il two. Now, Tacrolimus is one of the immunosuppresent, which can inhibit the T cell immune activity.
One of the target for the Tacrolimus is the FKBP. This is one of the binding protein commonly known as FK 50 six binding protein. Now, Tacrolimus can bind to this FKBP such that it can form a complex with calcium urine, which inhibits the acuity of calcium urine. This results in the reduced activation of NF 80. So NFAT undergoes defosphorylation, resulting in the inactivation.
Finally, this results in the decreased gene transcription and reduced release of Il two. In this way, Tacrolimus can suppress the immune response by reducing the gene transcription and Il Two production. Now, let us the precautions of this drug.
One of the important precautions of Tacrolimus is that this drug can reduce the immunity, so it can reduce the T cell activity. Because of reduced immune response, it can increase the risk of infections, particularly viral infections are increased, so risk of virusella doser infections, herpasimplex viral infections can be increased when this cream is applied topically.
That’s why Tacroma scream should be used after removing any topical infection because this can reduce the immunity and can further increase the viral infections. Similarly, this drug can produce some skin burning as well as it can produce proritis resulting in the itching. These two effects are observed with the staccroma screen and these can be observed even after Fiores. After application of the screen. At an average, skin burning sensation can be observed within 15 minutes of the application and proritis can be observed within 20 minutes, but they can be extended up to few hours.
So carcinogen should be taken when these are more pronounced in the patients. And in case of severe allergic reactions, this drug should be withdrawn. Similarly, this drug can increase the risk of phototoxity, even it is not completely phototoxic, but it can increase the risk of UV radiation cathogenicity, so it can increase the risk of cancer formation on exposure to the high radiation of UV light and it can also increase the skin tumors when the person is exposed to harmful radiation. That’s why Tacrolima should be carefully used and direct exposure to the sunlight or harmful radiation should be avoided in order to reduce the phototoxity. And this drug should not be given to the children with scaly skin disorders.
For instance, nethertense syndrome is one of the condition with red and scaly skin on which if Tacrolimus is applied, it can more absorbed into the systemic circulation, resulting in toxic effects. So in such conditions, Tacrolimus should not be used. Again, caution should be taken because Tacrolimus can increase the swelling of lymph nodes. Even this effect is more pronounced by systemic root. But still, care should be taken when this drug is applied by topical root because of any minor absorption through the skin.
Similarly, when our Tacrolimus is applied, the closure dressing should not be placed because they can increase the systemic absorption. With increased systemic absorption, Tacromas produce immunosuppression, resulting in viral infections, swelling of limbs. That’s why when this cream is applied, a closed dressing should not be placed in order to reduce a systemic absorption. Now let us see the side effects of this drug. Most of the side effects are local reactions and few of the side effects can be observed due to systemic absorption.
Tacrolims can produce skin burning, erythema, redness of the skin, pruoritous, eating sensation. Some allergic reactions can be produced by this drug and it can also produce some dry skin, which further increase the skin burning and tingling sensation. It can also produce rhinitis, headache, skin infections. Because this drug is a immunosuppressant, it can increase the further skin infections and diarrhea. Flu like symptoms can be observed with this Tacrolimas.
How it is given this drug is available as an ointment for topical purpose. For systemic purpose, it is available as a capsule, but topically it is applied as an ointment at two strengths 0.3% and 0.1%. The low concentration that is 0.3% is indicated for the treatment in the pediatric patients. So in the children with ace two to 15 years, this drug can be given for topical treatment of atopic dermatitis. Similarly, in the adults we can use a 0.1%.
So that’s about this drug Tacrolimus, which is a immunosuppressant. This drug reduce the T cell activity and T cell proliferation by inhibiting the gene transcription and proliferation of Il two and other immune mediators. Due to the decreased immune response, it can reduce inflammatory reactions associated with immune activity. And this drug can be used both in the pediatrics as well as in the adults. In the children with age less than two years, this drug is not indicated because of immune suppression.
This drug can increase the risk of skin infections and it can support some skin burning skin, dryness itching and this drug, when applied on the skin, the patient should not be directly exposed to the sunlight to reduce the development of any phototoxity.
