Kanamycin
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Kanamycin is an antibiotic of the aminoglycoside group.
Release form and composition
Kanamycin is available in the following dosage forms:
- Powder for preparation of a solution for intravenous and intramuscular administration (in 10 ml vials, 1, 10, 50 vials in a cardboard box);
- Powder for preparation of a solution for intramuscular administration (in 10 ml vials, 1, 5, 10, 50 vials in a cardboard box);
- Powder for preparation of solution for injections (in vials, 1, 10, 50 vials in a cardboard box).
The composition of 1 bottle contains the active substance: kanamycin - 500 or 1000 mg (in the form of monosulfate).
Indications for use
- Infectious and inflammatory diseases of the respiratory system, including pneumonia, lung abscess, pleural empyema;
- Severe purulent-septic diseases, including peritonitis, meningitis, sepsis, septic endocarditis;
- Purulent complications that develop in the postoperative period;
- Urinary tract and kidney infections, including cystitis, pyelonephritis, urethritis;
- Pulmonary tuberculosis and tuberculosis diseases of other organs caused by mycobacterium tuberculosis, showing resistance to anti-tuberculosis drugs of the I and II series and other anti-tuberculosis drugs, except for florimycin;
- Infected burns and other diseases caused mainly by gram-negative microorganisms (Klebsiella pneumonia, E. coli, Serratia, Enterobacter aerogenes, Salmonella, Proteus spp., Shigella), showing resistance to other antibiotic drugs, or associations of gram-negative and gram-positive pathogens.
Contraindications
- Neuritis of the VIII pair of cranial nerves;
- Severe chronic renal failure with azotemia and uremia;
- Pregnancy;
- Hypersensitivity to the components of the drug (including a history of other aminoglycosides).
Kanamycin should be used with caution in nursing women, elderly patients, premature babies and children under 1 month of age, as well as patients with myasthenia gravis, parkinsonism, renal failure and botulism (aminoglycosides can lead to disruption of neuromuscular transmission, which will further weaken skeletal muscle).
Method of administration and dosage
Kanamycin is administered intramuscularly, intravenously (drip), intracavitary.
When administered intravenously (drip), a single dose (500 mg) should be dissolved in 200 ml of 5% dextrose solution. The drug is administered at a rate of 60-80 drops per minute.
In the treatment of infections of non-tuberculous etiology, the adult single dose is 500 mg, the daily dose is 1000-1500 mg (every 8-12 hours, 500 mg). The highest daily dose is 2000 mg. The duration of the therapeutic course is 5-7 days. For children, Kanamycin is administered only intramuscularly at 50 mg / kg per day. For premature babies and children of the first month of life, the drug is prescribed only for health reasons.
In the treatment of tuberculosis, Kanamycin is administered intramuscularly. The dosage regimen is determined by age:
- Adults: 1000 mg once a day or 500 mg twice a day;
- Children: 15-20 mg / kg per day (maximum - 500-750 mg per day).
A break should be taken every seventh day of treatment.
In the cavity (pleural, abdominal, articular) Kanamycin is administered for washing. Single dose - 10-50 ml of 0.25% aqueous solution.
Intraperitoneally, 500 mg of a 2.5% solution is injected.
When carrying out peritoneal dialysis, it is necessary to dissolve 1000-2000 mg of Kanamycin in 500 ml of dialysis fluid.
In the form of warm-humid inhalation and aerosol (at a solution temperature of 35-40 ° C) Kanamycin is used in the treatment of infections of the respiratory tract of non-tuberculous etiology and pulmonary tuberculosis. To do this, 250-500 mg of the drug should be dissolved in 3-5 ml of distilled water or 0.9% sodium chloride solution. The frequency of administration is 2 times a day. The following dosage regimen is used (single / daily dose):
- Adults: 500 / 500-1000 mg;
- Children: 5/15 mg / kg.
The duration of therapy is determined by the indications: acute diseases - 7 days, chronic pneumonia - 15-20 days, pulmonary tuberculosis - 30 days or more.
The scheme of administration for patients with renal insufficiency should be adjusted by decreasing doses or increasing the intervals between injections (for the calculation it is recommended to use the following formula: interval between injections in hours = plasma creatinine content (mg / 100 ml) × 9).
The initial dose of Kanamycin is calculated based on body weight (dose, mg = body weight × 7). To calculate subsequent doses, the initial dose must be divided by the serum creatinine content (mg / 100 ml).
Frequency rate of application - 2-3 times a day. On the days of hemodialysis after hemodialysis, an additional single dose of the drug should be administered.
To avoid overdose, it is recommended to periodically monitor the concentration of Kanamycin in the patient's blood.
Side effects
During the use of Kanamycin, the following side effects may develop:
- Urinary system: nephrotoxicity - functional disorders of the kidneys (thirst, increase or decrease in frequency of urination, microhematuria, cylindruria, albuminuria);
- Nervous system: weakness, drowsiness, headache, neurotoxic disorders (epileptic seizures, tingling and numbness, muscle twitching, paresthesia), possibly impaired neuromuscular transmission;
- Gastrointestinal tract: functional liver disorders (hyperbilirubinemia, increased activity of hepatic transaminases), nausea, diarrhea, vomiting;
- Sense organs: ototoxicity (feeling of stuffiness or ringing in the ears, hearing loss up to irreversible deafness), toxic effects on the vestibular apparatus (dizziness, discoordination of movements, vomiting and nausea);
- Hematopoietic organs: thrombocytopenia, leukopenia, anemia, granulocytopenia;
- Allergic reactions: itching, skin rash, fever, flushing of the skin, Quincke's edema.
special instructions
During the period of use of Kanamycin, the function of the vestibular apparatus, auditory nerve and kidneys should be monitored at least 1 time in 7 days.
The likelihood of developing nephrotoxicity is higher in patients with functional impairment of the kidneys, as well as with the use of high doses of the drug or with prolonged therapy (such patients may require daily monitoring of renal function).
If the results of audiometric tests are unsatisfactory, the dose of Kanamycin should be reduced or its use should be discontinued.
Patients with infectious and inflammatory diseases of the urinary tract should take an increased amount of fluid.
Aminoglycosides penetrate into breast milk in small quantities (there were no complications associated with the use of the drug in infants, since the active substance is poorly absorbed from the gastrointestinal tract).
In the absence of positive clinical dynamics, it is necessary to take into account the possibility of the development of resistance of microorganisms. In these cases, it is necessary to discontinue the drug and initiate appropriate therapy.
Drug interactions
Kanamycin is pharmaceutically incompatible with gentamicin, streptomycin, penicillins, monomycin, heparin, capreomycin, cephalosporins, erythromycin, amphotericin B, and nitrofurantoin.
With the simultaneous use of Kanamycin with certain drugs, undesirable effects may occur:
- Polymyxins, nalidixic acid, vancomycin, cisplatin: an increased likelihood of developing nephro- and ototoxicity;
- Penicillins, cephalosporins, diuretics (especially furosemide), sulfonamides, nonsteroidal anti-inflammatory drugs: blocking the elimination of aminoglycosides, increasing their concentration in the blood serum, which leads to increased nephro- and neurotoxicity;
- Indomethacin (parenteral administration): an increase in the risk of developing the toxic effect of Kanamycin (an increase in T 1/2 (half-life) and a decrease in clearance);
- Anti-myasthenic drugs: reducing their effect;
- Curariform drugs, general anesthetics and polymyxins: enhancement of their muscle relaxant action;
- Polymyxins for parenteral administration, methoxyflurane and other drugs that block neuromuscular transmission (opioid analgesics, halogenated hydrocarbons as drugs for inhalation anesthesia), transfusion of large quantities of blood with citrate preservatives: increased risk of respiratory arrest (due to increased neuromuscular blockade).
Analogs
Kanamycin analogs are: Kanamycin sulfate, Kanamycin-KMP.
Terms and conditions of storage
Store in a dark place, out of reach of children, at temperatures up to 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
