Tobramycin

Tobramycin - bactericidal antibiotic of the aminoglycoside.

Pharmacological action

Tobramycin bactericidal effect on microorganisms. He breaks  Tobramycin Solution
 their vital functions by blocking one of the ribosomal subunits, and thus gives the protein synthesis in the microorganism. If used to the maximum permissible doses, the drug may damage the cytoplasmic membrane of bacteria.

Tobramycin has instructions on a wide range of actions detrimental acting on gram-positive and gram-negative bacteria that are sensitive to it. It is especially effective against various Staphylococcus aureus (including resistant to penicillin antibiotics), tsitrobakter, some types of streptococci, Escherichia, Haemophilus influenzae, and Pseudomonas sticks, Klebsiella, enterobacteria, Proteus, morakselly, atsinetobaktera, some Neisseria.

Studies have shown that Tobramycin is able to inhibit the ability to live, even those bacteria that are resistant to other aminoglycosides - gentamicin.

Well studied pharmacokinetics Tobramycin. It is poorly absorbed by ingestion. When injected into the muscle of the drug rapidly enters the bloodstream, reaching a maximum concentration of 0, 5 - 1, 5 hours. It almost does not bind to plasma proteins. Good pass through the placenta, but does not penetrate the blood-brain barrier to the brain.

Antibiotic well into the peritoneal fluid, sputum and joints. In patients with impaired renal filtration and newborns Tobramycin content in the blood, more and lasts longer in time.

Withdrawal from the body takes place unchanged by the kidneys.

Form release Tobramycin

The drug is released in the form of powder for solution for injection, and Tobramycin solution in ampoules.

Indications Tobramycin

Tobramycin is used to treat infections caused by susceptible to the microorganism, including - bone infection (osteomyelitis), joints (arthritis), biliary tract, central nervous system (meningitis), respiratory (pneumonia, lung abscess, empyema), abdominal (peritonitis), soft tissue and skin, urinary tract infections (cystitis, pyelonephritis), sepsis.

Because of the ability to effectively inhibit the ability to live Pseudomonas aeruginosa tobramycin solution for inhalation in patients with cystic fibrosis, since 6 years with this organism often infests the airways.

Antibiotic found topical application in ophthalmology in bacterial diseases of the eye and appendages of the eye (conjunctivitis, keratitis, blepharitis, and others.).

Contraindications

As with other aminoglycosides, tobramycin ototoxic and  Tobramycin in vial
 nephrotoxic, so it is not used in severe renal insufficiency, as well as the hearing impaired. Also according to the instructions Tobramycin is contraindicated in hypersensitivity to aminoglycoside antibiotics.

During pregnancy and breastfeeding in the decision about the use of this antibiotic should weigh the risk / benefit. Tobramycin is approved for use from birth.

With care and the minimum effective dose of the drug used in botulism, myasthenia gravis, dehydration, renal failure in the elderly.

Instructions for use Tobramycin

The antibiotic can be administered intravenously, intramuscularly, topically and by inhalation. To prepare a solution for intramuscular injection, the powder in the vial should be dissolved in 3 - 5 ml of 0 5% novocaine. For intravenous administration it is dissolved in 100 - 200 ml of 0 9% sodium chloride or 5% glucose solution. Dose is calculated per kg body weight. For newborn babies it is 2 - 4 mg / kg / day in 2 administration, the maximum of 5 mg / kg / day. From 2 months to 1 year Tobramycin calculated for 6 - 7, 5 mg / kg / day in a 3 - 4. For children older than 1 year and adults - 3 mg / kg / day in 3 - 4 administration. The course of treatment the individual is determined by the nature of the disease and its severity. On average it is 5 - 10 days, but can be extended to 3 - 6 weeks. For patients with kidney disease the dose is reduced and increase the interval between doses.

In inflammatory diseases of the eye Tobramycin used topically, instillation of 1 - 2 drops every 4 hours. In cystic fibrosis tobramycin solution is added to the nebulizer, and breathe it every 8 hours.

During treatment should monitor the function of the kidneys, liver and hearing.

Side effects

Tobramycin under the instruction has many undesirable effects - allergic reactions, nausea, vomiting, diarrhea, disorders of the blood system, blood chemistry changes, irreversible hearing loss, headache, drowsiness, sensory disturbances, seizures, impaired kidney function, candidiasis and mouth ulcers.





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