Amikacin

Details About Generic Salt ::  Amikacin 

Main Medicine Class:: Anti Infectives   Sub Medicine Class ::  Aminoglycosides

13A. AMINOGLYCOSIDES in 13. ANTI-INFECTIVES
AMIKACIN
AMINOGLYCOSIDE | ANTI-INFECTIVE
PK: A: Poorly absorbed D: 0.25 L/kg (Vd) E: Urine (94% to 98%)

Indications & Dose: ACTIVE TUBERCULOSIS Combination therapy IV/IM Adult 15mg/kg/day (up to 1g) given as a single daily dose (usually 750-1000mg/day) 5-7 times weekly for first 2-4 months or until culture conversion, dose can be reduced to 15mg/kg/day (up to 1g) given 2 or 3 times weekly (based on the efficacy of the other drugs in the regimen) Child <15 yr or <40kg: 15-30mg/kg/day (up to 1g) OD or twice wkly, >15 yr or >40 kg: Same as adult dose | FEBRILE NEUTROPENIA Empirical therapy IV Adult 7.5mg/kg BID with IV ceftazidime/cefepime Child 1-17 yrs: 20mg/kg OD or 6.5mg/kg TID with IV ceftazidime | MENINGITIS IV/IM Adult 15mg/kg/day in 3 divided doses Child <7 days: 15-20mg/kg/day in 2 divided doses, >7 days: 20-30mg/kg/day in 3 divided doses (smaller dose & longer intervals in neonates <2 kg) | IT/IVT Adult 4-20mg as single dose in conjunction with IM/IV amikacin of 7.5mg/kg q12hcaused by susceptible Gram-negative bacteria | NEONATAL SEPSIS Acute IV Child Neonate: 15mg/kg q24h over 3-5min slowly | Acute IV/IM Child Neonate: Loading dose 10mg/kg then 7.5mg/kg q12h when used as multiple daily dose regimen | PSEUDOMONAL LUNG INFECTION IN CYSTIC FIBROSIS Acute IV Child 1 month–18 yr: 10mg/kg q8h, max 500mg q8hMultiple daily dose regimen | SERIOUS GRAM-NEGATIVE INFECTIONS RESISTANT TO GENTAMICIN Acute IV Adult Initially 15mg/kg/day in 2 divided doses, increased to 22.5mg/kg/day in 3 divided doses in severe infect, max 1.5g/day for up to 10days (max cumulative dose 15g) Child 1 month–12 yr: 7.5mg/kg q12h, 12–18 yr: 7.5mg/kg q12h, increased to 7.5mg/kg q8h in severe infect, max 500mg q8h for up to 10days (max cumulative dose 15g) | URINARY TRACT INFECT IV/IM Adult 250mg BID

Contra: Hypersensitivity, cross-sensitivity with other aminoglycosides, myasthenia gravis, prolonged use

Precautions: Renal impairment, neonates, infants & elderly, muscular weakness, obesity

ADR: Serious: hypotension, ototoxicity (auditory, vestibular), nephrotoxicity, neurotoxicity, Others: rash, nausea, vomiting, dyspnea, paresthesia, headache, arthralgia, drowsiness

DDI: Serious Neuromuscular blockers activity prolongs and causes fatal respiratory depression, Ceftriaxone causes nephrotoxicity, Amphotericin-B leads to nephrotoxicity

Diet:

Monitor: Urinalysis, BUN, SeCr, temperature, weight & hearing parameters

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