Follow the instructions the pharmacy gives you for storing the medicine and checking expiration dates. 0000011927 00000 n 0000022313 00000 n 0000096760 00000 n 0000024961 00000 n 0000010032 00000 n Use of Intravesicular Amikacin Irrigations 0000006402 00000 n Check to make sure it is clean before each time you rinse. Package and label. ARncsKk` '|FmHh+Azl Lj)p!C0j yA.0a6!1. 0000002734 00000 n 0000015856 00000 n H5074V0 BC -0 endstream endobj 392 0 obj 901 endobj 393 0 obj << /Filter /FlateDecode /Length 392 0 R >> stream Leave catheter in bladder after drainage Method of Preparation: Calculate the quantity of each ingredient for the amount to be prepared. the percentage of antibiotics on the susceptibility list of urine cultures will be compared between WebTwice daily intravesicular amikacin irrigations (15 mg/30 mL) were initiated with a dwell time of 2 hours. (Note: Sodium Chloride 0.9% Injection or Sodium Chloride 0.9% for Irrigation may also be used in the formula.) 0000004942 00000 n Webn! 0000028012 00000 n Clean your irrigating device before and after every use. Hb````g`c` ,@Q*`yI00XS!NjRXp Tc60Wtt#yXl7I3$00u070(4pt`Re`Pj DA)%eL 6p|r`*3`wA#4)3aS_L }4l:%1h^g\TR $8 l s )`rA@~ !T{ endstream endobj 470 0 obj 305 endobj 383 0 obj << /Type /Page /MediaBox [ 0 0 576 792 ] /Parent 378 0 R /Resources << /Font << /F0 387 0 R >> /XObject 384 0 R /ProcSet 468 0 R >> /Contents 385 0 R /Thumb 363 0 R /CropBox [ 0 0 576 792 ] /Rotate 0 >> endobj 384 0 obj << /im1 401 0 R /im2 413 0 R /im3 401 0 R /im4 415 0 R /im5 417 0 R /im6 419 0 R /im7 421 0 R /im8 423 0 R /im9 425 0 R /im10 427 0 R /im11 429 0 R /im12 431 0 R /im13 433 0 R /im14 435 0 R /im15 437 0 R /im16 439 0 R /im17 441 0 R /im18 443 0 R /im19 445 0 R /im20 447 0 R /im21 449 0 R /im22 451 0 R /im23 453 0 R /im24 455 0 R /im25 457 0 R /im26 459 0 R /im27 461 0 R /im28 463 0 R /im29 465 0 R /im30 467 0 R /im31 400 0 R >> endobj 385 0 obj [ 389 0 R 391 0 R 393 0 R 395 0 R 397 0 R 399 0 R 403 0 R 407 0 R 409 0 R 411 0 R ] endobj 386 0 obj << /Type /FontDescriptor /FontName /Arial /Flags 32 /FontBBox [ -250 -212 1213 1000 ] /MissingWidth 277 /StemV 80 /StemH 80 /ItalicAngle 0 /CapHeight 905 /XHeight 453 /Ascent 905 /Descent -212 /Leading 150 /MaxWidth 1011 /AvgWidth 441 >> endobj 387 0 obj << /Type /Font /Subtype /TrueType /Name /F0 /BaseFont /Arial /FirstChar 32 /LastChar 255 /Widths [ 278 278 355 556 556 889 667 191 333 333 389 584 278 333 278 278 556 556 556 556 556 556 556 556 556 556 278 278 584 584 584 556 1015 667 667 722 722 667 611 778 722 278 500 667 556 833 722 778 667 778 722 667 611 722 667 944 667 667 611 278 278 278 469 556 333 556 556 500 556 556 278 556 556 222 222 500 222 833 556 556 556 556 333 500 278 556 500 722 500 500 500 334 260 334 584 750 556 750 222 556 333 1000 556 556 333 1000 667 333 1000 750 611 750 750 222 222 333 333 350 556 1000 333 1000 500 333 944 750 500 667 278 333 556 556 556 556 260 556 333 737 370 556 584 333 737 552 400 549 333 333 333 576 537 278 333 333 365 556 834 834 834 611 667 667 667 667 667 667 1000 722 667 667 667 667 278 278 278 278 722 722 778 778 778 778 778 584 778 722 722 722 722 667 667 611 556 556 556 556 556 556 889 500 556 556 556 556 278 278 278 278 556 556 556 556 556 556 556 549 611 556 556 556 556 500 556 500 ] /Encoding /WinAnsiEncoding /FontDescriptor 386 0 R >> endobj 388 0 obj 232 endobj 389 0 obj << /Filter /FlateDecode /Length 388 0 R >> stream The com-bination of irrigation and debridement is a hallmark in the management of device-related infections [1,4]. 0000070718 00000 n GSKsource. Mupirocin calcium (Bactroban, MW 1075.34, C52H86CaO18.2H2O) occurs as a white to off-white, crystalline solid that is freely soluble in dehydrated alcohol and is very slightly soluble in water. WebAn article addressing the subject of Gentamicin instillations recommends a mixture of 480mg Gentamicin in one Liter of 0.9% normal saline.1 We use this recipe but cut it in 0000013293 00000 n Gentamicin Injection USP is compatible and stable for 24 hours when diluted to 0.35-0.7 mg/mL with either 0.9% Sodium Chloride Injection or Dextrose Injection 5%. Accurately weigh the quantity of mupirocin 2% ointment. 0000075365 00000 n The usual dose is 50 milliliters (ml). Chronic bladder infection using a Gentamicin bladder wash 0000075342 00000 n Gentamicin, Neomycin, and Polymyxin B Bladder Irrigation The inactive ingredients are benzyl alcohol, cetomacrogol 1000, cetyl alcohol, mineral oil, phenoxyethanol, purified water, stearyl alcohol, and xanthan gum.5, Sodium chloride 0.9% solution contains not less than 95.0% and not more than 105.0% of the labeled amount of sodium chloride in purified water. ~~7;0:VPOxhU|10W0(QKhs=@Z8& UA#XAab>pDb]Wc_:kzM.7FGg9#yV9g/?. ^g]52@)# ngi"J2h?D [?brb`z-&_bb}(ze)VoWixxMpJ5 lQb>%Ni-N7{(;A^Jb5/HiQ]QitQfvBayhD{Q~R DS@:L0.! Gentamicin sinus irrigation is a compounded medicine made by a special pharmacy. 0000008888 00000 n 0000024983 00000 n Data collected include demographic, co-morbidities, urological anomalies, symptoms, documented pathogens during episodes of infection, and irrigation medication used. Do not administer if patient allergic to Amphotericin. 0000019021 00000 n 0000002271 00000 n 0000018998 00000 n 0000002335 00000 n Dissolve the powders in sufficient Sterile Water for Irrigation to final volume and mix well. Bactroban ointment. Maximilien JS. Gentamicin What is sinus irrigation? What will I need to buy? Mix Together OR USE NEILMED POWDER FOR NORMAL SALINE AVAILABLE AT THE PHARMACY AND FOLLOW THEIR DIRECTIONS 1 NASAL IRRIGATION DEVICE (SINUS RINSE WebKeep the rest of the solution in the refrigerator. 0000027989 00000 n U.S. Pharmacopeia/National Formulary [current revision]. Use: Mupirocin is an anti-infective agent used in the topical treatment of infections that are caused by Staphylococcus aureus, beta-hemolytic Streptococcus, and Streptococcus pyogenes. 0000098176 00000 n Add sufficient sodium chloride 0.9% solution slowly, with mixing, to final volume. 0000063857 00000 n 0000048148 00000 n hb```g``a`a` @1V $`pua]}yr Ug4jInLvjy#`Acd6l @NFGCkG6s - F^0-E_';R?cZ@U g7_Hs PiU1L2`(/TD e`Q3n0 WD 130 0 obj <>stream x\i_iE-gVZd;#%8K%WN~ $RC''ZonKOWV?UhUA[ui0u7gl}ookxpPT_b|P-Y00BzPcVg>~wJ^Q+uDWo~?xrM9NUa{>71 6c)F]b$chAl_U ^*jTAu+3h`A7jPhKhY${X;AEF, Sb(\BUxb0JP+2>Lo1HkAPVwXkPnPC-SgYoxvp E Qyph#-8H%pFjP}dI:qf0\,F( `"!H,:5tn".^s 95.-gV_]u&w'p/3;ajh+CGteodGA`a&!!MEj%&!a!L&ZCp>yO]G=*#JX'q^r_vCgz6cu(dC-OU}]3Mf}0qb>tieyqMRugCu]V0/fSCW]2\KX f6+{crd+}'#(W&+NO zsL] C9025 ~j0FTg@!EGJG/Lo4+o|^O9$.$3[ hXn6~nCQJ@v]qCX,9&}CQ$+q0(,e xXxvx{.+Y?+0!%l. a1#s1 8v(\6x"kK+>s=qO+hRtU`|IA:V\-l!_S 2aZ> Each gram of Bactroban 2% ointment contains 20 mg mupirocin in a water-miscible ointment base (polyethylene glycol ointment, NF) consisting of polyethylene glycol 400 and polyethylene glycol 3350.3 As discussed below, it is also available as mupirocin calcium in a cream and as nasal ointment containing paraffin and a mixture of glycerin esters (Softisan 649). Accurately weigh or measure each ingredient. Wilsons solution, a combination of Gentamycin or Tobramycin and normal saline solution, is the classic antibiotic irrigation. Each patient instilled 30 to 60 mL of GS solution twice a day at the conclusion of a regularly scheduled catheterization. 0.2 ml into a 200 ml bottle for a final concentration of 30 g/ml Gentamicin and 15 ng/ml Amphotericin. Irrigation with antibiotic-containing solutions for the DpX5L!i&a0o/! WebObjective: To determine if gentamicin nasal irrigation is systemically absorbed, and to identify any ototoxic side effects related to its use. Accessed March 6, 2019.5. Bactroban nasal. 0000089577 00000 n ]t0[+ C endstream endobj 390 0 obj 22 endobj 391 0 obj << /Filter /FlateDecode /Length 390 0 R >> stream RxList. Nasal irrigation instructions 0000011992 00000 n However, the nasal ointment cannot be used for this nasal spray or drops because it does not mix well with the sodium chloride 0.9% solution. It is important to clean the tip of the applicator nozzle or dropper following each administration. 0000002171 00000 n Study design: Prospective, INTRAVESICAL INSTILLATION OF GENTAMICIN Accessed March 6, 2019.4. Her serum creatinine improved from 2.46 mg/dL to 1.32 mg/dL and her blood urea nitrogen improved from 51 mg/dL to 24 mg/dL (Figure). 0000044733 00000 n How to Irrigate. The usual dose is 50 mL. You may let the solution you measured out warm up for 30 minutes before you use it. Keep the rest of the solution in the refrigerator. Add the gentamicin solution to your normal saline sinus rinse and irrigate the right nostril with half of the bottle, then the left with the remaining amount. Design: Retrospective review of 12 patients treated with gentamicin nasal irrigations (30 cc of 80 mg/L solution used bilaterally twice daily). In laminar air-flow hood withdraw 0.78mL of Gentamicin 40mg/mL. WebTransfer amount of Gentamicin instructed above into catheter tip syringe Catheterize bladder per usual routine and drain bladder. PROTOCOL FOR GENTAMICIN BLADDER Rockville, MD: U.S. Pharmacopeial Convention, Inc; March 2019.2. For the nose. 0000079773 00000 n Bactroban cream. Treatment Options for Chronic Rhinosinusitis | Proceedings of the HVn7[ b9.j"}QXjwv\-l 3sL+ 55?f~~Ol`M\p@+?eU4u`Lt5`R(~[PdW@pM?ni.]CyP2ty ydNbdN|mcz|Hh3DCp.7z]4n N'%H"eAUvcbsa`rjQe$\ASES WXHm!0rq>;>VM{2o>|*=.wZ*q= jm`l!C}ni?lWVr!W Xo_'Na']O7#Ln"TD@b9_(fn29y. %PDF-1.3 n*/"389|%\ayt,1'XNul4)3)~8be=Ap| 0000026007 00000 n Set aside Note: Nasal sprays and drops for topical application do not need to be sterile. Using a 60 cc catheter tip syringe, draw up _____ ml of Gentamicin Solution (480 mg Gentamicin in 1 Liter 0.9 Normal Saline) into syringe and gently push all the air out. WebHow do I use the gentamicin sinus irrigation? The Effect of Gentamycin in the Irrigating Solution to All rights reserved. To comment on this article, contact rdavidson@uspharmacist.com. Package and label. Two instillation volumes (8 mg gentamicin in 20 mL 0.9% NaCl or 20 mg gentamicin in 50 mL 0.9% NaCl) were used to suit different bladder capacities. A bag of 1000 mL normal saline with 160 mg gentamicin bladder irrigation solution was prepared in the operating room (OR) prior to surgery. 0000007742 00000 n 0000092992 00000 n Nasal Irrigation Accurately weigh or measure each ingredient. Gentamicin Bladder Instillations: Instructions for 0000063880 00000 n Rinse both nostrils with the gentamicin solution 2 times a day for two weeks unless your healthcare provider asked you to use it for a longer amount of time. Sterile-filter into Add the gentamicin solution to your normal saline sinus rinse and irrigate the right nostril with half of the bottle, then the left with the Usually this rinse is good for 14 days and needs to be stored in a refrigerator. 0000003571 00000 n Bladder Instillations | Interstitial Cystitis Association Citations/References 1. 0000016644 00000 n 0000060144 00000 n 0000004964 00000 n Gentamicinnasalirrigations(typicallyforPseudomonas )infections)) Add!one!ampule!of!gentamicin! (except the urinary bladder) after local irrigation and after topical application during surgical procedures. Gentamicin is an aminoglycoside antibiotic used in the treatment of several gram-negative infections. They need to be sterile only if they are used for nasal inhalation. Web1. https://gsksource.com/bactroban_cream. Ingredients QS Quantity Units Gentamicin 40mg/mL 0.78 mL Gentamicin Ophthalmic Solution 3mg/mL 5 mL . 0000007719 00000 n 1. trailer << /Size 471 /Info 379 0 R /Root 381 0 R /Prev 648753 /ID[<5543beeeac3d209cd3687f836ebb2d80><5543beeeac3d209cd3687f836ebb2d80>] >> startxref 0 %%EOF 381 0 obj << /Type /Catalog /Pages 378 0 R /PageMode /UseThumbs /OpenAction 382 0 R >> endobj 382 0 obj << /S /GoTo /D [ 383 0 R /FitH -32768 ] >> endobj 469 0 obj << /S 140 /T 318 /Filter /FlateDecode /Length 470 0 R >> stream 0000031838 00000 n Accurately weigh or measure each ingredient. WebHow to prepare 160 mgs Gentamicin/1 liter of Saline irrigation- Mix 2 of 80mg/2ml vials with 1 liter/quart of saline (either homemade saline or 0.9% Sodium Chloride in liter Note expiration date of irrigant solution 6. WebThe proportion of multidrug resistant organisms decreased, and the rate of gentamicin resistance did not change. Verify the patients allergy history. 0000016667 00000 n 0000044756 00000 n Another Treatment for Chronic UTIs: Gentamicin 0000010582 00000 n }78JGZEuoI>Uw ,]Imp p!>p#cT4j-]z[CVS>{ug lA5q*6Eu8Y8&xAPZpP(3C1 Is that solution for IV or irrigation?: Fluid administration Webon GS irrigation. 2. B3DuaNhK?`kQZxq-Uw+/uqgro:c5GSI0rjL.p^gIe Hl}k&[F.N7\U} {6=#eT6oU\eFsrs]vJ?r?.323mTTEd'KF%&M/^w:m:aI?T =s4W`|KNeMzB^%*h#2\m%#c_@NOsc'4BY!73. endstream endobj startxref 0000056052 00000 n Mupirocin is used as a topical antibacterial agent in skin infections, especially impetigo, and in nasal carriage of methicillin-resistant S aureus. endstream endobj 87 0 obj <> endobj 88 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/Thumb 65 0 R/Type/Page>> endobj 89 0 obj <>stream Gentamicin is an antibiotic medicine that is used to treat and prevent urinary tract infections (UTIs). Gentamicin Sinus Irrigation |Sinus Treatment| Dr. Ashley GSKsource. Sinus Irrigation With Gentamicin Pour the gentamicin solution into the sinus rinse bottle and irrigate the right nostril with half of the bottle, then the left with the remaining amount. www.rxlist.com/bactroban-ointment-drug.htm#indications. It should be indicated based on patient age, symptoms, signs at presentation, and local antimicrobial resistance patterns to enhance the probability of successful treatment in bacterial septicemia, meningitis, urinary tract infections, 4 0 obj WebCompoundingToday.com | Formulation: Clindamycin 100-mg, Gentamicin 100-mg and Polymixin B Sulfate 200,000-Units in Sterile Sodium Chloride 0.9% Irrigation Solution Formula Information Click on the component link for advanced information from the physicochemical database. Loyd V. Allen, Jr., PhDProfessor EmeritusCollege of PharmacyUniversity of Oklahoma, Oklahoma City. Sodium chloride solutions are chemically and physically stable. Antibiotic regimen included: gentamicin, gentamicin alternated with piperacillin-tazobactam, or tobramycin once weekly. 0000060121 00000 n 0000005297 00000 n Las Vegas, NV 89128, Copyright 2023 Nevada Sinus Relief | Design and Development by. Add sufficient sodium chloride 0.9% solution slowly, with mixing, to final volume. Mupirocin (Bactroban, Centany, C26H44O9, MW 500.62) occurs as a white to off-white, crystalline solid that is freely soluble in dehydrated alcohol and very slightly soluble in water. Web2. 0000070741 00000 n 1999;3:146-147.3. How do I use the gentamicin sinus irrigation? WebObjectives/hypothesis: To compare efficacy and outcome of daily saline irrigation versus saline/gentamicin for treating chronic rhinosinusitis (CRS). 0000084472 00000 n Accurately weigh the quantity of mupirocin 2% ointment. It contains an antibiotic called gentamicin and it is mixed into normal saline. Put lubricant 8th ed. X0+id}bTsd$g~f-6>2xlXw$n[.)o|L,V:XF;+PLCf9Jc:y!D}EVD5C in Normal Saline Nasal Suspension You may let the solution you measured out warm up for 30-45 minutes or until room temperature before you use it. IJPC. To Measure out 0000006425 00000 n WebPatients in Group 1 (Saline) received intra-articular irrigation with normal saline (0.9 % sodium chloride) solution, while those in Group 2 (Gentamycin) received intra-articular Verify the irrigating solution against the doctors order for dose, rate of irrigation, and duration of irrigation 5. Note that 2.15 mg of the calcium form is equivalent to 2 mg of mupirocin.3, Bactroban (mupirocin calcium) 2% nasal ointment contains the dihydrate crystalline hemicalcium salt of mupirocin. This should go away after the first few times you use it. Stability: As a topically applied formulation, a beyond-use date of 30 days may be used for this preparation.1, Quality Control: Quality-control assessment can include weight/volume, pH, specific gravity, active drug assay, color, rheologic properties/pourability, physical observation, and physical stability (discoloration, foreign materials, gas formation, mold growth).2. Irrigation To compare the rate of antibiotic resistance of isolated pathogens when participants develop a urinary tract infection during the 3 months follow up period after intra-vesical antibiotic instillation vs. oral antibiotic suppressive therapy. 0000005276 00000 n Irrigation solution: Component 1: Component 2: Component 3: Component 4: Betadine (Povidone Iodine) + Antibiotics: 500cc Betadine (10% Povidone Iodine) 1g Antibiotic Bladder Instillations vs. Oral Suppression for Wound Care Therapy Copyright 2000 - 2023 Jobson Medical Information LLC unless otherwise noted. Sodium chloride. To clean the bottle, wash it with warm, soapy water and let it air dry or follow the cleaning instructions that came with your device. gentamicin 0000010297 00000 n 0000048171 00000 n WebSet aside until ready to connect to catheter and insert into bladder. Rinse the syringe out with warm soapy water and allow to dry. Do not put syringe into boiling water or the microwave to disinfect syringe as it may melt or come apart. 7. The Gentamicin solution can be stored in room air. %PDF-1.5 % Sodium chloride is soluble in water to the extent of 1 g in 2.8 mL water, and it is slightly soluble in alcohol (1 g in 250 mL of 95% ethanol).6. Method of Preparation: Calculate the quantity of each ingredient for the amount to be prepared. Attach a 0.22micron filter and mix injectable solution with 5mL Gentamicin ophthalmic solution. You may feel mild burning or stinging when you rinse with the solution. It can be given directly into the bladder through a catheter which is Gentamicin Bladder Instillations: Instructions for The nasal ointment is a white to off-white ointment that uses 2.15% w/w mupirocin calcium (equivalent to 2% mupirocin free acid) in a soft, white ointment base. The irrigation is given twice a day for 7 days in the treatment regime or once a day, every other day, in the prophylactic regime. Packaging: Package in either a nasal spray or dropper container. 0000065819 00000 n %PDF-1.3 % Toggle the visibility of the Accessibility Toolbar, SinuMed Sinus Cleansing System (available for purchase from our office or, Large medical syringe to measure out 50 cc or ml of solution. Check to make sure it is clean before each time you rinse. This pseudomonic acid antibiotic produced by Pseudomonas fluorescens has a narrow spectrum of activity and is primarily employed against gram-positive bacteria. USP General Chapter <800>: A Pharmacy Professionals Guide to Handling and Compounding Hazardous Drugs, Standard Treatment for Pneumonia Usually Equal to More Powerful Antibiotics, Management of Complicated Skin and Soft Tissue Infections in Hospitalized Patients, Evaluation of the Treatment of MRSA Infections. Keep the rest of the solution in the refrigerator. Irrigation affords a three-fold benet: First, it serves to hydrate thebed;second, toassist in betterexamination ofthe 0000040166 00000 n 0000002756 00000 n GA-1000 is included in all Clonetics TM Primary Cell Culture Media Kits. The inactive ingredients are paraffin and a mixture of glycerin esters (Softisan 649).4, Bactroban (mupirocin calcium) 2% cream contains the dihydrate crystalline hemicalcium salt of mupirocin. 0000031815 00000 n Handbook of Pharmaceutical Excipients. 0000097072 00000 n 0000065796 00000 n Nasal!irrigationinstructions! 380 0 obj << /Linearized 1 /O 383 /H [ 2335 421 ] /L 656483 /E 98447 /N 6 /T 648764 >> endobj xref 380 91 0000000016 00000 n 110 0 obj <>/Filter/FlateDecode/ID[<8EC72C7E6BE2056B3C44ABA458D3413E>]/Index[86 45]/Info 85 0 R/Length 110/Prev 272567/Root 87 0 R/Size 131/Type/XRef/W[1 2 1]>>stream 0000097094 00000 n 0000015834 00000 n 0000013270 00000 n Topical therapy with antibiotics such as gentamicin or tobramycin for patients with CRS can be effective in reducing pain, mucosal edema, secretions, and postnasal drip, especially after Baby shampoo irrigations led to subjective improvement in SNOT 22 scores for 46.6% of patients who were previously symptomatic despite Nasal & Sinus Rinses / Nebulization Bactroban cream is a white cream that contains 2.15% w/w mupirocin calcium (equivalent to 2% mupirocin free acid) in an oil-in-waterbased emulsion. 160mg Gentamycin in 1 L of NS is the Doughman DJ; Philadelphia Harper and WebOpen wound treatmentis an aggressive method, which has the dis-advantage of requiring persistence of the wound.Closed techniques are usually preferred, espe-cially during the 1. We recommend use at a 1:1000 ratio (i.e. 0000020661 00000 n 0000035827 00000 n WebGentamicin 0.16 Nystatin 0.5 ml (500 ml sodium chloride) Gentamicin 1mg/gm Clindamycin 1mg/gm Polymyxin 2,000 U/gm Nystatin 100,000 U/gm (HEC 4% gel) Quantity: 20 gm 50 gm 100 gm Directions: Sig (specify):_____ Polymyxin 10,000 U/gm Refills: x _____ Bacitracin 500 U/gm (powder) Custom Combinations 0000008865 00000 n Accessed March 6, 2019.6. 0000017963 00000 n 0000017941 00000 n percial irrigation before skin closure is another common practice, but involving less than 12L of solution. 0000084495 00000 n 0000005421 00000 n 0 Discard after ____ [time period]. Labeling: Keep out of reach of children. The usual dose is 50 mL. London, England: Pharmaceutical Press; 2017:854-857. 1105, .fl-node-brjsa2hy5039.fl-row-fixed-width, .fl-node-brjsa2hy5039 .fl-row-fixed-width {max-width: 800px;}.fl-node-nuir7k62ysmp {width: 100%;} .fl-node-nuir7k62ysmp > .fl-col-content {margin-bottom:20px;}.fl-node-8ckzv9ywm7ps {width: 100%;}.fl-node-8ckzv9ywm7ps > .fl-col-content:after {background-color: rgba(226,132,50,0.26);}.fl-node-8ckzv9ywm7ps > .fl-col-content {background-image: url(https://nevadasinusrelief.com/wp-content/uploads/2020/07/sidebar1.jpg);background-repeat: no-repeat;background-position: center top;background-attachment: scroll;background-size: cover;border-top-left-radius: 15px;border-top-right-radius: 15px;border-bottom-left-radius: 15px;border-bottom-right-radius: 15px;} .fl-node-8ckzv9ywm7ps > .fl-col-content {margin-bottom:10px;}.fl-node-y7bjsd2u1rkm {width: 100%;}.fl-node-y7bjsd2u1rkm > .fl-col-content:after {background-color: rgba(226,132,50,0.26);}.fl-node-y7bjsd2u1rkm > .fl-col-content 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