If necessary, the appointment of antibiotics in some cases decide in favor of the drug "Gentamicin." Instructions for use indicate the pronounced activity of the active compound, as well as the strong effect of its use. The product is commercially available as a solution for injection into a vein and muscle tissue. In tablet form, the medication is not produced. You can also buy Gentamicin Akos. The instructions for use for this ointment indicate that it is based on the same active compound as the solution for injection.
Solution: general information
According to the instructions for use, gentamicin sulfate is the main component of the drug "Gentamicin". In addition to the active compound, the medication contains a number of additional substances that provide storage duration and ease of use. Trilon B, special purified water and sodium metabisulfite are present in the solution. The product must be transparent, colorless or light in color.
The instructions for use of "Gentamicin" (tablets with the same name are not allowed, only a solution for injection) specifies that the product belongs to the class of aminglicosides.
Pharmacology
Following the instructions for use, Gentamicin (an injection solution is available in ampoules) is used as a bactericidal antimicrobial agent. It has a wide range of efficiencies. The active compound, getting into the human body, enters into strong bonds with the subunit of the ribosome, inhibits protein synthesis, prevents the formation of informational, transport RNA. This leads to incorrect transfer of information and the formation of non-functional proteins, thereby inhibiting the vital activity of the pathological cell. The bactericidal property of the drug is proven. With an increased concentration of a substance in the medium, the barrier function of the membrane cytoplasm decreases. This leads to the mass death of pathological life forms.
Forms and Names
In the instructions for the use of Gentamicin injections, the manufacturer indicates an increased sensitivity to the medication of a fairly large range of gram-negative pathological microorganisms. You can use the drug in question for diseases caused by certain varieties of Proteus, Eicheria, Salmonella, Shigella, Klebsiella. "Gentamicin" is effective when infected with staphylococci, pseudomonads, cytobacter and some other types of microorganisms.
Tests have shown that neisseria, treponema, streptococci, bacteroids, and some types of clostridia are resistant to Gentamicin.
The instructions for the use of Gentamicin injections indicate the possibility of a combination of the drug with representatives of the penicillin series. This allows you to successfully treat infection with enterococci, streptococci.
Important Nuances
It was revealed that microscopic life forms slowly gain resistance to the active component of Gentamicin. If resistance to cana, neomycin is inherent in some form, it is highly likely that resistance will also be revealed to gentamicin. The drug is ineffective in diseases caused by protozoa, fungi, viruses.
Before the initial use of the composition, it is reasonable to conduct research to clarify its effectiveness. It is strictly forbidden to use the drug of your choice. As can be seen from the many reviews, the instructions for use of "Gentamicin" also draws attention to this. People who use the medicine as part of a therapeutic course agreed with the doctor recognize its effectiveness and pronounced effect. Those who used Gentamicin inadvertently and uncontrollably were more likely to experience side effects and an unsatisfactory outcome of the treatment program.
Kinetics
Shortly after administration of the drug, absorption processes occur intramuscularly, the effectiveness of which is estimated at 100%. The duration of reaching the maximum concentration in the circulatory system with this form of administration is from half an hour to an hour and a half. With a half-hour infusion intravenously, the maximum concentration is achievable in half an hour, with an hourly procedure - in a quarter of an hour. When using the drug in a dosage of 1.5 mg / kg, the maximum concentration of the drug in the patient's body is 6 μg / ml.
The instructions for use of Gentamicin (in gynecology, surgery and other areas of medicine, the drug was widely used due to its pronounced antibacterial, bactericidal properties) indicate a low level of entry into strong bonds with serum proteins: on average, such complexes form only 10% of the substance. The volume of free distribution for adult patients is estimated at 0.26 l / kg, for children, the indicator varies between 0.2-0.4 l / kg. When using Gentamicin for the treatment of newborns up to a week old with a weight of up to 1.5 kg, the distribution volume is approximately 0.68 l / kg. At the same age, with a larger mass, the indicator reaches 0.58 l / kg.
Kinetic features
The instructions for use of "Gentamicin" indicate that the active substance in concentrations sufficient to achieve a therapeutic effect is detected in the respiratory system, kidneys, and liver. "Gentamicin" is found in biological fluids, including lymph, synovial, pleura and others. Analyzes made it possible to determine that the compound enters the pus, wound secretion, granulation, urine. Relatively low concentrations are found in adipose tissue and muscle, bone, watery ocular. "Gentamicin" is defined in the secretion of the bronchi, sputum, breast milk, bile, spinal fluid. In the treatment of adult patients in a predominant percentage of cases, the medication does not pass through the blood-brain barrier. It is allowed to use the drug for meningitis, since in this case the concentration of the drug in the fluid of the spinal cord reaches therapeutic.
When treating infants, it is necessary to take into account that the content of "Gentamicin" in the spinal cord of patients is typically higher than in older people. The ability of the antibiotic to penetrate the placenta was revealed.
In the instructions for use of "Gentamicin" the manufacturer specifies the impossibility of metabolic processes involving the active component in the human body. The half-life of adult patients from the body on average is estimated at 2-4 hours, for children older than a week, but younger than six months, from three to three and a half hours. When using Gentamicin for the treatment of premature babies and infants whose body weight is more than 2 kg, the half-life reaches 5.5 hours, under the same conditions, but weighing 1.5-2 kg - 8 hours, with even less - 11, 5 hours
Elimination, cumulation
The manufacturer clarifies in the instructions for use of "Gentamicin": the release of the drug mainly occurs through the kidneys, the substance does not transform. A relatively small percentage is eliminated with bile. During normal kidney function, up to 95% of the incoming compound is excreted on the first day. The concentration in urine reaches 100 μg / ml. With a reduced ability of the kidneys to glomerular filtration, elimination slows down.
In the instructions for use of "Gentamicin" (eye drops with gentamicin, too), the manufacturer indicates the excretion of the drug through blood dialysis. On average, after five hours of the procedure, the concentration decreases by half. Peritoneal dialysis is somewhat less effective. To remove a quarter of the drug, 48-72 hours are required.
Repeated use allows you to achieve a cumulative effect. It is most pronounced in the lymphatic intra-aural regions, in the tubules of the kidneys (proximal section).
When will it help?
As follows from the instructions for use, Gentamicin injections in gynecology, pulmonology, surgery and other medical fields are widespread when bacterial infections are needed if the causative agent is sensitive to this antibiotic. You can use the drug for pulmonary inflammation, pleurisy, empyema, bronchitis, pyelonephritis, cystitis, prostatitis, endometritis, osteomyelitis, peritonitis, meningitis, blood poisoning. The drug is used to disinfect wounds and treat burns. "Gentamicin" is indicated for otitis media.
In some cases, a medication is also used to treat animals. In the instructions for use of "Gentamicin", sold in a regular pharmacy, there are no direct indications of this, so it is unacceptable to use it on your own. If the doctor prescribes an antibiotic, he gives a clear explanation of how to enter, how often to repeat the procedure, what should be the duration of treatment. The format for veterinarians can be bought at a specialized pharmacy.
When is it dangerous?
It is forbidden to use "Gentamicin" if hypersensitivity or an allergic reaction to the main component of the medication is established. You can not use the composition if in the past a reaction of hypersensitivity was observed against the background of the use of other aminoglycosides.
The drug is contraindicated in case of neuritis of the nerve responsible for hearing, in severe renal failure, accompanied by uremia, azotemia. An antibiotic is not used during the period of gestation.
Possible but neat
It is allowed to take "Gentamicin" with regular monitoring of the body's response, if the patient has myasthenia gravis or kidney failure. Attention is required by elderly patients and people with parkinsonism. Against the background of botulism, the described antibiotic and other representatives of aminoglycosides can cause impaired transmission of impulses between the nervous and muscular systems, which provokes weakening of the musculature of the skeleton. "Gentamicin" is used very carefully with general dehydration.
If necessary, the selection of therapy for the child, pregnant and lactating mothers take into account that the use of the composition is associated with an increased likelihood of a toxic effect on the kidneys, ear system. Gentamicin is allowed to be used only when there is no alternative, the patient urgently needs treatment and it does not seem to adjust the therapeutic course to a safer one.
Externally and internally
With a number of diagnoses, Gentamicin Akos ointment is prescribed. The instructions for use of this drug indicate that the product belongs to the class of antibacterial, based on gentamicin. The mechanism of operation of this drug is similar to the described solution, but the tool has a pronounced local effect. According to the instructions for use, the ointment "Gentamicin Akos" must be used strictly under the supervision of a doctor. Self-medication with this drug is unacceptable.
Like the solution, the medication for external use is used to treat infectious diseases provoked by sensitive microflora. The drug is indicated if it is necessary to disinfect areas affected by insect bites. The instructions for use of the ointment "Gentamicin Akos" mention the effectiveness of the medication for skin abscesses, secondary infection, dermatitis. The medication is used if necessary to treat burns and wounds. Gentamicin is used to treat ulcerated skin areas, including ulcers provoked by varicose veins.
Terms of use
Gentamicin solution is used parenterally. For intravenous, intramuscular administration with moderate severity of the condition, the optimal dosage is 3 mg / kg daily. The resulting volumes are divided into 2-3 procedures. The substance is diluted with saline or a five percent dextrose solution. The total volume administered should vary between 50-300 ml. For children, volumes are shown less, while the maximum permissible concentration of the drug is 0.1%.
If the disease is severe, the drug should be used in a larger dosage: 5 mg / kg. The frequency of procedures is up to four per day. When the patient's condition becomes better, the dosage is reduced to the above.
In infectious processes, foci of inflammation in the urinary system with adequate kidney function, Gentamicin is indicated once a day. The volume of administration is 120-160 mg. The duration of the course is from a week to 10 days. If gonorrhea is detected, "Gentamicin" is used once. Dose - 240-280 mg.
The nuances of using
When prescribing Gentamicin injections for children over two years of age, the dose is selected based on weight, 3-5 mg / kg is prescribed per day. Frequency of use - thrice daily. For babies whose age is less than a week, as well as for premature infants, the daily dose of the drug is 6 mg / kg, the multiplicity is twice a day. Before the age of two, you should use the medicine three times a day, the dose is calculated as 6 mg / kg.
In case of impaired renal excretory function and in old age, with severe burns, the appointment of "Gentamicin" should be strictly individual. First, the serum concentrations of gentamicin, which are characteristic for a particular case, are determined, on the basis of which a safe and effective treatment regimen is selected.
In severe infectious diseases, the brevity of use should be increased with a decrease in a single dosage of the drug. With ascites, swelling, excess weight, it is necessary to calculate the dose based on dry weight. In case of renal impairment and blood dialysis, the drug is used after the session in an amount of 1-1.7 mg / kg. For children, the optimal format is 2-2.5 mg / kg.
Negative consequences: what is possible?
The manufacturer draws attention to the possibility of vomiting and nausea while taking the drug. There is a chance of activation of liver enzymes in the circulatory system, as well as an increase in the concentration of bilirubin. Improper and unreasonable use of "Gentamicin" with a high degree of probability provokes anemia, leuko-, granulocyte-, thrombocytopenia. There is the possibility of nervous twitching, craving for sleep, seizures of epilepsy. It is known that against the background of the use of Gentamicin in children, psychosis is possible.
The manufacturer warns that "Gentamicin" is toxic to the kidneys and may cause a violation of the functionality of this body. In certain cases, there is the likelihood of tubular necrotic processes. Also, the substance is toxic to the hearing aid, can cause hearing impairment and noise, various disorders. There is a risk of deafness. This side effect is irreversible.
Gentamicin may provoke an allergic response in the body. There is a risk of angioedema, fever, eosinophilia, rashes, and itchy patches of skin. It is possible to reduce the concentration of magnesium, potassium, calcium in the body - this is more common in children. In addition, the use of "Gentamicin" is associated with the risk of the formation of resistant strains, the development of superinfection.
Too much!
An overdose of Gentamicin is indicated by a decrease in the conductivity of nerve impulses to muscle tissue, which causes respiratory arrest. To correct the condition, urgent use of anticholinesterase drugs, proserin, calcium compounds is necessary. Before using proserin, you need to enter 0.5-0.7 mg of atropine into the body, wait for the pulse to stabilize, only after that enter the main drug (proserin). The initial dose is 1.5 mg. If this volume does not give a pronounced result, the same amount of drug substance is reintroduced. In a particularly severe case, artificial pulmonary ventilation is required.
It is allowed to remove the antibiotic with dialysis or peritoneal. The first method is more effective.