As with other antibiotics, against the background of using the drug Colistin, strains of resistant microorganisms can appear. After the cancellation and / or replacement of therapy, it is possible to restore the effectiveness of the drug.
Colistin as an inhaled monotherapy should not be used to treat exacerbations of chronic infection caused by Pseudomonas aeruginosa.
Inhalational use of the drug Colistin can cause acute bronchospasm in patients with hypersensitivity.In this regard, the introduction of the first dose of Colistin for inhalations should be carried out under the supervision of experienced medical personnel who have experience in the treatment of cystic fibrosis, and inhalation should be preceded by the use of a bronchodilator if this is included in the treatment regimen of this patient. Before and after inhalation of the drug, Colistin should measure the volume of forced expiration in the first second (OOBi). If a patient who does not receive bronchodilator has signs of medically conditioned bronchial obstruction, the next application of the drug Colistin should be repeated a trial (FEVD, adding a bronchodilator.
In case of hemoptysis use, the risk-benefit ratio should be taken into account, since inhalations of Colistin may increase cough.
Patients with impaired renal function should carefully monitor the possibility of developing side effects from the nervous system and regularly monitor kidney function. Care should be taken when treating patients taking co-nephrotoxic drugs, it is necessary to monitor kidney function regularly.Joint use of neurotoxic drugs should be conducted with caution under the supervision of a physician.
In porphyria, it must be taken into account that the use of Colistin can strengthen the clinical manifestations of this disease.
When carrying out inhalation treatment with dornase alpha and Colistin, a break between inhalations should be made.
Directions for proper use:
To use antibiotics in the form of an aerosol, spray nebulizers (jet or ultrasonic) are recommended, which, when used with the appropriate compressor, should create most of the inhalation particles with a diameter of not more than 5 μm (for the most effective absorption by the lungs). When using and maintaining the nebulizer / nebulizer and compressor, follow the manufacturer's instructions. Standard nebulizers / nebulizers create a continuous aerosol flow, so the particles of the sprayed sodium colistimethate can evaporate into the environment. To avoid this, it is recommended to use standard nebulizers in well-ventilated rooms.The use of appropriate filters / valves will help minimize the evaporation of sodium colistimethate into the atmosphere. 1. The bottle with powder is opened by removing the aluminum cap with the control of the first opening and opening the rubber stopper.
2. An ampoule with 3 ml of physiological solution applied as a solvent is opened using a saw or an apparatus for opening ampoules.
3. The contents of the ampoule are completely poured into a vial of powder. The powder is dissolved by gentle shaking.
Strong shaking should be avoided due to excessive formation of foam.
4. The solution is poured into a nebulizer and is administered by inhalation according to the instructions of the nebulizer manufacturer. The inhalation procedure is considered complete after the full use of 3 ml of the inhalation solution.
5. The patient performs the inhalation procedure of the preparation Colistin in a sitting or standing position vertically, in a normal calm state, producing as deep as possible inhalations through the mouthpiece of the nebulizer. To facilitate inhaling through the mouth allows the use of a nasal clamp.
6. After each use, the mouthpiece should be rinsed and disinfected, and the manufacturer's instructions should be followed.
In patients receiving such types of inhalation therapy as bronchodilators, inhalation use of the drug Colistin should be carried out immediately after their use, as well as after physiotherapy procedures on the chest. The prepared solution of the drug Colistin should not be mixed with other drugs.
The solution should be freshly prepared immediately before inhalation. The drug should be stored in its original packaging to protect the contents from exposure to light. The contents of the vial are intended for single use only, the unused remedy is to be disposed of.