Gentamicin - instructions for use, doses, side effects, contraindications

Antibiotic from the group of aminoglycosides. Linked from 30S-subunit of the ribosomes of the bacterial cell and disrupts the movement of the ribosome along the filaments PHK. Also changes the process of reading the code PHK, which leads to the synthesis of functionally inactive proteins. Is able to disrupt the permeability of the cytoplasmic membrane of microorganisms. Has a bactericidal type of action against Neisseria gonorrhoeae, including strains producing penicillinase.

Pharmacokinetics:

With intramuscular injection gentamicin quickly absorbed: bactericidal concentration in the blood serum is achieved 1 hour after the injection and persists for 8-12 hours. With intravenous drip introduction, the concentration of antibiotic in the blood plasma during the first hours exceeds the concentration that is reached by intramuscular injection of the drug. The connection with plasma proteins is about 10%. Not exposed to metabolism. Penetrates through the planetary barrier.

The half-life is 2-4 hours. Elimination by the kidneys.

Indications:

It is used to treat bacterial infections caused by sensitive microorganisms: infections of the upper and lower respiratory tract (including bronchitis, pneumonia, pleural empyema), complicated urogenital infections (including pyelonephritis, cystitis,urethritis, prostatitis, endometritis), bone and joint infections (including osteomyelitis), skin and soft tissue infections, abdominal infections (peritonitis, pelvic inflammation), infections of the central nervous system (including meningitis), gonorrhea, sepsis, wound and burn infection, otitis.

ICD-10

I.A30-A49.A40 Streptococcal septicemia

I.A30-A49.A41 Other septicemia

X.J10-J18.J13 Pneumonia caused by Streptococcus pneumoniae

X.J10-J18.J15 Bacterial pneumonia, not elsewhere classified

X.J85-J86.J86 Pythothrace

XI.K65-K67.K65 Peritonitis

XI.K80-K87.K81.0 Acute cholecystitis

XI.K80-K87.K83.0 Cholangitis

XII.L00-L08.L01 Impetigo

XII.L00-L08.L02 Abscess of skin, boil and carbuncle

XII.L00-L08.L03 Phlegmon

XII.L00-L08.L08.0 Pyoderma

XII.L20-L30.L21 Seborrheic dermatitis

XII.L60-L75.L73.8 Other specified diseases of follicles

XIII.M00-M03.M00 Pyogenic arthritis

XIII.M86-M90.M86 Osteomyelitis

XIV.N10-N16.N10 Acute tubulointerstitial nephritis

XIV.N10-N16.N11 Chronic tubulointerstitial nephritis

XIV.N30-N39.N30 Cystitis

XIX.T20-T32.T30 Thermal and chemical burns, unspecified

XIX.T79.T79.3 Post-traumatic wound infection, not elsewhere classified

Contraindications:

Severe renal failure with azotemia (residual nitrogen in the blood above 150 mg%) and uremia, diseases of auditory and vestibular, cochlear neuritis, myasthenia gravis, idiosyncrasy.

Carefully:

Botulism, parkinsonism, myasthenia gravis, renal failure, dehydration, neonatal period, prematurity of children, advanced age.

Pregnancy and lactation:

Recommendations for FDA - category D. Contraindicated during pregnancy and lactation.

Dosing and Administration:

Use in children

Newborns and infants: 6-7 mg / kg per day.

Older than 2 years: 1.2-5 mg / kg per day in 2-3 injections.

Adults

Intramuscularly: 3 mg / kg body weight in 2-3 injections.

Intravenously: 3 mg / kg body weight in 5-15 ml sodium chloride solution 0,9% or 5% glucose solution.

The highest daily dose: 5 mg / kg.

The highest single dose: 3 mg / kg.

Side effects:

Central and peripheral nervous system: neuromuscular blockade, respiratory arrest.

Digestive system: candidiasis, nausea, vomiting, malabsorption syndrome.

Sense organs: deafness.

Urinary system: toxic nephrosis.

Dermatological reactions: Candidiasis, itching, burning with local application.

Allergic reactions.

Overdose:

Stop breathing.

Treatment: hemodialysis, oxygen therapy, anticholinesterase drugs, calcium salts.

Interaction:

Simultaneous use with anesthetics, inhalation of halogenated hydrocarbons, blockers of neuromuscular transmission, massive transfusions of citrated blood increases the risk of blockade of neuromuscular transmission.

Simultaneous use with warfarin enhances the therapeutic effect.

When used simultaneously with other aminoglycosides, the risk of ototoxicity increases.

The risk of nephrotoxicity increases with simultaneous use with amphotericin B, aldesleukin, salicylates, acyclovir, bacitracin, carmustine, ifosfamide, preparations of gold and lithium, sulfonamides, cytostatics.

Special instructions:

When parenteral administration can sometimes cause the development of curare-like symptoms.

Instructions

Gentamicin (Gentamycinum)