Tobramycin

Details About Generic Salt ::  Tobramycin 

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

13A. AMINOGLYCOSIDES in 13. ANTI-INFECTIVES
TOBRAMYCIN
AMINOGLYCOSIDE | ANTI-INFECTIVE
also comes under 3C. Anti-Infectives in 3. Ocular
PK: A: Poor (PO), Rapid (IM) D: 0.2-0.3 L/kg (adults), 0.2-0.7 L/kg (child) M: Not metabolised E: Urine

Indications & Dose: CYSTIC FIBROSIS IV/IM Adult 300mg q12h as repeated cycles of 28days on drug followed by 28 days off drug Child 2.5-3.3mg/kg q6-8h | ENDOCARDITIS Combination therapy/Prophylactic therapy IV/IM Adult 1.5mg/kg with ampicillin 30min prior to procedure | INFECTIVE ENDOCARDITIS IV/IM Adult 1mg/kg q8h with ampicillin | MENINGITIS IV Adult Loading dose 2mg/kg, then 1.7mg/kg q8h (given with another bacteriocidal) Child 0-7days: <2 kg: 2.5mg/kg q18-24h, >2 kg: 2.5mg/kg q12h, 8-28days: <2 kg: 2.5mg/kg q8-12h, >2 kg: 2.5mg/kg q8h. Can also given as IM | PELVIC INFLAMMATORY DISEASE IM Adult Loading dose 2mg/kg, then 1.5mg/kg q8h | SUPERFICIAL EYE INFECT TP Adult Ointment: Instill 1/2 (1.25 cm) 2-3 times/day, for severe infections apply q3-4h; Solution: Instill 1-2 drops q2-4h, for severe infect instill up to 2 drops q1h until improved, then reduce to less frequent intervals Child >2 months : Same as adult dose

Contra: Hypersensitivity

Precautions: Myasthenia gravis, parkinson’s disease, renal impairment, obesity, elderly

ADR: Serious: ototoxicity, nephrotoxicity, tubular necrosis, toxic nephropathy, respiratory paralysis, respiratory depression, tinnitus, increased liver enzymes, hemolytic anemia, anaphylaxis, Others: erythema, nausea, vomiting, increases salivation

DDI: Serious Sucralfate decreases drug efficacy, Cefalotin/Amphotericin-B/Cefazolin/Cefotaxime/Cefoxitin/Ceftazidime/Ceftriaxone/Cefuroxime/Ciclosporin/Cisplatin/Clindamycin increases risk of nephrotoxicity, Neuromuscular blockers leads to fatal respiratory depression, Miconazole reduces drug level

Diet:

Monitor: Renal parameters, PFT, urine output, BUN, SeCr

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