The discovery of antibiotics is one of the main achievements of man in the field of medicine. Thanks to these drugs, today it is possible to treat a huge number of bacterial infections that previously could not be defeated. Over the past decade, a huge number of drugs of this group have appeared. For example, the drug "Amikacin" (Latin name - amikacini sulfatis), which refers to aminoglycosides, has a wide spectrum of action, high therapeutic efficacy and proven healing properties.
Structure
The drug is a white powder of amikacin sulfate (in Latin - amikacini sulfatis).
To obtain the finished dosage form, it is necessary to dilute the substance with water for injection.
The procedure for administering the drug is quite painful, therefore, as an additional solvent, another 0.5% novocaine solution or 2% lidocaine solution is added to the water. These funds act as painkillers and facilitate the patient's condition during injection.
Dosage form
Amikacin is available in the form of a white powder intended for the preparation of an injection solution that can be administered both intravenously and intramuscularly.
Powder in the amount of 250, 500 or 1000 mg is packaged in clear glass bottles, which are then placed in 5, 10 or 50 pieces in paper packaging along with instructions for use.
According to the instructions, Amikacin tablets do not exist.
Mechanism of action
The drug has a bactericidal effect, which is the binding of the 30S ribosomal subunit and bacterial cells. As a result, protein synthesis is inhibited and the bacterium is no longer capable of division. Thus, "Amikacin" destroys pathogenic microorganisms, and also prevents the multiplication of mycobacteria - pathogens of tuberculosis.
Indications for use
Since the substance has a wide spectrum of action, the list of indications for use with Amikacin is quite large. This includes infections caused by both gram-positive and gram-negative microorganisms:
- bronchitis,
- pneumonia,
- lung abscess
- pleural epidemic,
- sepsis,
- endocarditis,
- meningitis,
- cystitis,
- pyelonephritis,
- peritonitis,
- osteomyelitis and many other diseases.
- Also, "Amikacin" is often used in ophthalmic practice for the treatment of bacterial ocular infections (conjunctivitis, keratitis, blepharitis).
Among other things, the drug belongs to anti-TB drugs and can be used to treat this disease.
Contraindications
"Amikacin" - a drug that has a systemic effect on the human body. Therefore, there are a number of conditions in which the use of this drug is strictly prohibited. These include:
- The presence of allergy to amikacin sulfate or any other antibiotic of the aminoglycoside group.
- Since the drug has an ototoxic effect, it is prohibited for use in patients with diseases of the auditory apparatus (inflammation of the auditory nerve, for example).
- In addition, Amikacin negatively affects the excretory function of the kidneys, therefore it is prohibited for use in patients with insufficiency of this organ, as well as with uremia, azotemia.
Use with caution
There are also several categories of people in whom treatment with Amikacin should be carried out with extreme caution.
- Patients suffering from myasthenia gravis (an autoimmune disease with extremely fatigue of some muscle groups) or Parkinson's disease.
- Patients with dehydration.
- Elderly people.
- Newborn babies (especially premature babies).
Side effects of the drug
Like any other antibiotic, Amikacin can adversely affect the human body and some of its systems. Therefore, during treatment with this agent, a number of undesirable side reactions may occur:
- Nausea and vomiting, abdominal pain, stool disorder.
- In a blood test, an increase in the level of bilirubin and liver transaminases is possible.
- Allergic reactions in the form of an itchy rash on the skin, in rare cases, the development of Quincke's edema is possible.
- Amikacin sulfate has an effect on the composition of the blood. The results of laboratory tests, as a rule, indicate a decrease in the level of platelets, leukocytes, granulocytes and hemoglobin.
- May cause headaches, dizziness, drowsiness.
- Significant hearing loss until complete disappearance
- The appearance of protein in the urine (proteinuria) is likely.
Use in pregnant and lactating women
"Amikacin" (in Latin - amikacinum) is strictly contraindicated for pregnant women who are at any time of gestation. Under no circumstances should you use the drug while in this position. Otherwise, it can negatively affect the formation and development of the fetus.
"Amikacin" (in Latin - amikacinum) belongs to category D among drugs that have an effect on the fetus. This means that its side effects are proven and can cause significant damage to the health of the unborn child (impaired or lack of hearing, pathology of the internal organs, and so on).
If there is an urgent need to use the medicine, then the nursing woman will have to decide on the termination of lactation.
Features of the use of the drug
This drug before use requires compliance with certain conditions and the consideration of certain aspects.
The drug is administered in the form of injections. Only in this way will it have its healing effect.
If air enters the syringe or if the process is not sterile, the consequences can be very serious. Therefore, it is extremely important to administer the medicine correctly. It is better if this is carried out by a specially educated person in a hospital.
For young children, a 2 ml syringe is used, for all others - 5 ml.
The algorithm for using Amikacin is as follows:
- First of all, you need to open the bottle with the medicinal powder.
- Then add the necessary amount of water for injection, novocaine (or lidocaine) there, mix the components and collect the resulting solution with a syringe.
- If intravenous infusion is necessary, the powder should be dissolved in 200 ml of water for injection or saline.
- Wipe the puncture site with an antiseptic (in adults it is usually a vein on the elbow, in young children - on the outside of the hand).
- The drug is administered either intramuscularly, or intravenously dropwise (about 1 drop per second), or intravenously (slowly, the entire amount of the solution is administered slowly over two minutes).
Another feature that must be considered when using this antibiotic is its nephrotoxicity. Therefore, in patients with impaired renal function, it is extremely important to reduce the dose of the drug and administer it at longer intervals.
To find out the optimal length of such gaps, the patient must take a blood test for serum creatinine concentration. The result should be multiplied by 9. The resulting number will denote the amount of time required (in hours).
When treating amikacin sulfate, it is important to consider its interaction with other drugs.
Drug Interactions Amikacin
- Mutually enhances the action of antibiotics such as benzylpenicillin, cephalosporins (Cefuroxime, Ceftriaxone, Cefazolin).
- When used with beta-lactam antibiotics, the therapeutic effectiveness of Amikacin may be reduced. This is especially true for people suffering from severe renal failure.
- The toxic effect of the drug on the auditory and renal systems is increased when combined with nalidixic acid (Negram, Nevigramon), polymyxin B (Sabvixin), cisplatin and vancomycin.
- The same is true when using diuretics ("Furosemide" and the like), sulfonamides ("Biseptol"), non-steroidal anti-inflammatory drugs ("Ibuprofen", "Paracetamol") together with "Amikacin".
- This antibiotic has the ability to enhance the muscle relaxant effect in curare-like drugs ("Tubarin", "Ditilin").
- The risk of respiratory arrest in that patient who is simultaneously prescribed Amikacin and polymyxins in the form of injections is increased. The same is true in the case of opioid analgesics.
- With the simultaneous parenteral administration of amikacin sulfate and indomethacin, the risk of side effects of the former increases.
- It is possible to reduce the therapeutic activity of anti-myasthenic drugs if they are prescribed simultaneously with this antibiotic.
- Also, Amikacin is incompatible with B vitamins and ascorbic acid.
Therefore, when prescribing the Amikacin prescription in ampoules in Latin, doctors should be tired of its pharmacological compatibility.
Dosage regimen
The drug is intended for injection use only and can be administered intravenously or intramuscularly.
Dosage depends on the weight of the patient.
For all people whose age has reached 6 years, the calculation is made according to the formula - 5 mg per 1 kg of body weight, inject every eight hours or 7.5 mg per kg of body weight, enter every 12 hours. The maximum allowable amount of the drug is 15 mg / kg per day. The duration of the treatment course depends on the method of administration of the substance, since the bioavailability of the drug is different.
- With intravenous administration, it is higher, and from 3 days to a week is enough for recovery.
- With intramuscular administration, it may take 10 days.
The calculation of daily and single doses in children under 6 years is different.
In newborns who were born prematurely and are premature, the initial dose is 10 mg per 1 kg of weight, then it drops to 7.5 mg every 24 hours. For all other children under the age of six, the dosages are similar but the interval between injections is reduced to 12 hours.
Overdose
The drug has a systemic effect, exerting its influence on all human organs. Therefore, it is extremely important to observe the rules of use and the dosage regimen. This will help to avoid an overdose, which can lead to serious consequences. For instance:
- blockade of nerves and muscles, complete respiratory arrest;
- depressed state of the central nervous system in the form of drowsiness, lethargy, stupor, falling into a coma.
If any of these symptoms occurs, you should immediately seek medical help from a medical organization, where an overdose will be treated with intravenous calcium chloride, subcutaneous Neostmgmina, using atropine and other drugs to symptomatically alleviate the patient's condition. In addition, when respiratory function is inhibited, an artificial lung ventilation apparatus can be used.
In case of impaired renal function, hemodialysis should be used. If the patient with an overdose is a newborn child, an exchange blood transfusion is used.
Storage conditions and shelf life
The drug should be stored in a dry place, away from sunlight. The temperature in the room should not exceed 25 degrees.
Adults should ensure that the Amikacin package is in a place that is out of the reach of children.
The shelf life of the drug is 2 years from the date of production. After this time, the use of the drug is strictly prohibited.
Under no circumstances should you store the opened bottle. One bottle - one application. And no other way. Only under such conditions the sterility of the drug is not violated.
Pharmacy Vacation Terms
Amikacin sulfate is an antibiotic. Therefore, it refers to prescription drugs. When he leaves the pharmacy organization, the pharmacist (or pharmacist) will certainly ask for an appointment from the attending physician. If the patient does not have a prescription, the pharmacy worker is forced to refuse to dispense the drug.
Amikacin. Latin Recipe
When prescribing this drug, the doctor is required to write a prescription on a strictly defined form of the form, indicating all the necessary details. After that, the document is given to the patient in his arms and he goes to the pharmacy to purchase the medicine.
The Amikacin recipe is written in Latin. The form of form No. 107-1 / y is used.
What the Amikacin recipe looks like in Latin, you can see the photo below.
However, having a prescription alone is not enough. It is necessary that the recipe "Amikacin" in Latin be correctly executed and have all the necessary details.
These include:
- stamp of a medical institution;
- date of prescription;
- the full name of the patient, his age category, number of years;
- full name of the doctor, his signature and seal.
In the column Rp (short for Recipe - "prepare"), the doctor indicates the name of the drug, its concentration, volume and number of ampoules.
For instance:
Rp: Solutionis Amikacini (Amikacin solution in Latin) 0.5 - 4 ml.
Dtd (Da tales doses - "give such doses") n 10 in ampullis.
This is what the Amikacin recipe looks like in Latin. For children, the dosage may vary. In standard cases, it is 0.25 grams per day.
Column S (short for signa - “designate”) for Amikacin ampoule prescription in ampoules in Latin is filled in by the doctor. It should indicate in detail how the medicine is applied, in what dosage and with what frequency the administration should be carried out.
An example of a signature for Amikacin in Latin:
S .: Introduce into the gluteal muscle 1 time per day for 10 days.
Latin amikacin sulfate prescription should be provided to the pharmacy. There, the pharmacist or pharmacist will select the right medicine, make the appropriate notes on the vacation and return the prescription form to your hands. In the pharmacy organization for storage the recipe "Amikacin" in Latin does not remain.
Conclusion
"Amikacin" is a drug with a wide scope and high therapeutic effect. However, when using it, it is necessary to take into account a number of features. Such as: rules for admission, dosage regimen and drug interaction with other substances.
Due to its belonging to the class of antibiotics, for the purchase of the drug, it is necessary to have a prescription "Amikacin" in Latin, prescribed by a doctor.
If the drug was used without medical prescription, this can lead to consequences: overdose, the occurrence of pronounced side effects and a violation of the sterility of the drug administration process, as a result of which an infectious process can occur. Therefore, the decision on treatment with Amikacin can only be made by a doctor.