Amikacin instructions for use
Amikacin is an antibacterial drug. The main active substance of this drug (amikacin sulfate) belongs to the group of antibiotics - aminoglycosides. Amicacin is active against most bacteria, which are the causative agents of infectious diseases.
Form of issue and composition
Amikacin is available in the form of a solution for injection in ampoules of 4 ml and powder for solution in vials. Ampoules are packaged in a contoured cell package, which contains 5 or 10 ampoules of solution. In one cardboard bundle, there may be 1 or 2 contourcell packings with an appropriate number of ampoules (5 and 10 pieces).
Powder for the preparation of the solution is available in vials. One cardboard pack can contain 1, 5 or 10 bottles.
The main active substance of the drug is amikacin sulfate. Its amount is 250 mg in 1 ml of the solution. It also includes auxiliary substances:
- Sodium Citrate for Injection.
- Sulfuric acid is diluted.
- Sodium disulphite.
- Water for injections.
In the vial of amikacin sulfate can be contained in several dosages - 250, 500 and 1000 mg. The different number of ampoules or vials in cardboard packages makes it possible to conveniently apply the drug depending on the prescribed course of treatment and dosage.
Amikacin is an antibiotic of the pharmacological group of the III generation aminoglycoside. It has a bacteriostatic effect (destroying bacterial cells) against a wide range of different bacteria. Destruction of the bacterial cell occurs due to binding to the subunit of the 30S ribosome and the disruption of the replication of protein molecules, which leads to the death of the bacterial cell. Amicacin is active against such groups of bacteria:
- Gram-negative bacteria (Gram stain pink) - Salmonella spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Shigella spp., Serratia spp., Providencia stuartii.
- Gram-positive bacteria (according to Gram are colored in violet) - Staphylococcus spp. and some strains of Streptococcus pneumoniae.
The drug does not have a bactericidal effect on anaerobic microorganisms (bacteria that can grow and multiply only in the absence of oxygen). Amikacin is effective against resistant bacteria against other antibiotics (penicillin-resistant strains of microorganisms).
After intramuscular injection, the active substance is rapidly absorbed into the blood and distributed in the body (within 10-15 minutes). Freely penetrates the blood-brain barrier, the placenta (penetrates the fetus during pregnancy), enters the breast milk. From the body of amikacin sulfate is excreted unchanged. Half-life (the time during which half of the total concentration of the active substance is excreted from the body) is 3 hours.
Indications for use
The main indications for the use of Amikacin are severe infectious diseases caused by gram-negative bacteria (especially if they have resistance to other antibiotics). Such diseases include:
- Infectious processes in the respiratory system - pneumonia (pneumonia), bacterial bronchitis , lung abscess (formation of a limited cavity filled with pus in the lung tissue), pleural empyema (accumulation in the pleural cavity of pus).
- Sepsis - an infectious process with the presence in the blood of pathogenic bacteria with their active growth and reproduction.
- Bacterial endocarditis is an infectious process (often purulent) of the inner shell of the heart (endocardium).
- Infectious process in the brain - encephalitis, meningoencephalitis, meningitis.
- Pathological bacterial process in the organs of the abdominal cavity, including peritonitis.
- Infections of the skin, subcutaneous tissue and soft tissues - abscesses, phlegmon, gangrenous processes, decubitus with necrosis, burns.
- Pathology of the liver and biliary tract - abscess of the liver, cellulose, cholecystitis , empyema of the gallbladder.
- Infectious processes in the urinary and genital system - pyelonephritis, urethritis, cystitis with frequent development of purulent complications.
- Wounds and postoperative infectious complications.
- Infections of bones ( osteomyelitis ) and joints (purulent arthritis).
Before using Amikacin, a laboratory determination of the sensitivity of the pathogen to this antibiotic is desirable.
Contraindications for use
Use of amikacin is contraindicated in such cases:
- Allergic reactions, individual intolerance to amikacin sulfate or any excipients of the drug.
- Diseases of the inner ear, which are accompanied by inflammation of the auditory nerve - amikacin sulfate in this case can lead to toxic nerve damage with deterioration or loss of hearing.
- Severe pathology of liver or kidney, accompanied by their functional insufficiency.
- Pregnancy at any time.
Determination of the presence of contraindications is carried out before the application of Amikacin.
Dosing and Administration
Amicacin is the parenteral form of the drug. It is administered intramuscularly or intravenously. The powder before the injection is dissolved in 2-3 ml of water for injection. The injection is performed in compliance with the rules of aseptic antiseptic to prevent infection of the injection site. The dosage of the drug is determined by the type of infectious process, its localization in the body and the severity of the flow. The standard dosage for adults and children from the age of one month is 5 mg / kg body weight, which are administered 3 times a day. It is also possible to administer 7.5 mg / kg body weight 2 times a day (daily dose of 15 mg). The course of treatment is an average of 10 days. The course dose of the drug should not exceed 15 g.
Amicacin sulfate or auxiliary components of the drug after ingestion can lead to the development of a number of side effects:
- Allergic reactions - the degree of severity can be different, from skin rash and itching to anaphylactic shock (the development of multiple organ failure with a decrease in systemic blood pressure). Also, a variant of an allergic reaction may be urticaria (a rash and a slight swelling of the skin, reminiscent of a nettle burn), Quincke's edema (pronounced localized edema of the skin and subcutaneous tissue predominantly in the face or genital area).
- Side effects on the part of the organs of the digestive system - an increase in the level of liver enzymes in the blood (ALT, AST), indicating the destruction of hepatocytes (liver cells), an increase in the concentration of bilirubin in the blood, nausea and vomiting.
- Negative reactions from the hematopoiesis system - leukopenia (decrease in the number of leukocytes), anemia (decrease in hemoglobin and the number of erythrocytes), thrombocytopenia (decrease in the number of platelets).
- Changes in the urinary system - albuminuria (the appearance of protein in the urine), microhematuria (the appearance of a small amount of blood in the urine), the development of renal failure.
The development of one of their side effects requires the withdrawal of the drug and the further conduct of symptomatic therapy.
Exceeding the permissible dose with Amikacin can lead to the development of such pathological reactions of the body:
- Ataxia - a violation of coordination, manifested in a change in gait (staggering gait).
- Ringing in the ears, sharp reduction of acuity of hearing up to its complete loss.
- Severe dizziness.
- Upset bladder.
- Thirst, nausea and vomiting.
- Impaired breathing, shortness of breath.
Treatment of overdose is carried out in the intensive care unit. For the early removal of Amikatsina from the body, hemodialysis (hardware blood purification) and symptomatic therapy are performed.
The use of the drug is possible only for the intended purpose and under the supervision of the doctor with the obligatory consideration of special instructions:
- Newborns and children under the age of 1 month, the drug is administered only on strict medical indications at a dose of 10 mg / kg of body weight, which is divided into 10 days.
- In the absence of therapeutic effect 48-72 hours after the start of therapy, it is necessary to resolve the question of replacing the antibiotic or treatment tactics for infectious pathology.
- With other drugs Amikacin is used with great care with constant monitoring of the functional activity of the liver, kidneys and central nervous system.
- With extreme caution Amikacin is used in people with myasthenia gravis (muscle weakness) and Parkinsonism.
Amicacin in pharmacies is only available on prescription.
Terms and conditions of storage
Shelf life Amikatsina is 3 years. Keep it in a dark, dry, cool place, out of the reach of children. Air temperature - not more than + 25 ° С.
Analogues of Amikacin
Preparations, in which the active substance is amikacin sulfate, are - Ambiotik, Lorikatsin, Flexetite.
Prices for Amikacin
Amikacin powder for the preparation of injection solution 500mg, 1 pc. - from 15 rubles.
Amikacin solution for intravenous and intramuscular injection 250 mg / ml, 20 pcs. - from 300 rubles.