황산 아미카신

동물 종별 용량

투여 경로

금기

• Hypersensitivity to aminoglycosides
• Generally contraindicated in rabbits/hares (adversely affects GI flora balance)

이상반응

• Nephrotoxicity (tubular necrosis)
• Ototoxicity (auditory and vestibular)
• Neuromuscular blockade
• Facial edema
• Injection site pain/inflammation
• Peripheral neuropathy
• Hypersensitivity reactions

약물 상호작용

• Beta-lactam antibiotics (penicillins, cephalosporins) · May have synergistic effects against some bacteria; potential for physical inactivation of aminoglycosides in vitro (do not mix together) and in vivo (patients in renal failure).
• Cephalosporins · Potentially could cause additive nephrotoxicity (controversial, well documented only with older agents like cephaloridine and cephalothin).
• Loop or Osmotic Diuretics (e.g., furosemide, torsemide, mannitol) · Concurrent use may increase the nephrotoxic or ototoxic potential of the aminoglycosides.
• NSAIDs · May cause nephrotoxic effects; concurrent use with aminoglycosides should generally be avoided.
• Other Nephrotoxic Drugs (e.g., cisplatin, amphotericin B, polymyxin B, vancomycin) · Potential for increased risk for nephrotoxicity.
• Neuromuscular blocking agents & General anesthetics · Concomitant use could potentiate neuromuscular blockade.

모니터링

• Efficacy (cultures, clinical signs, WBCs)
• Therapeutic drug monitoring (TDM) is highly recommended: Peak level should be at least 40 mcg/mL and the 4-hour trough sample less than 10 mcg/mL
• Renal function tests (BUN, creatinine) and urinalysis (USG, casts) pre-therapy and repeated during therapy
• Gross monitoring of vestibular or auditory toxicity

과용량

Should an inadvertent overdosage be administered, three treatments have been recommended: - **Hemodialysis:** Very effective in reducing serum levels but rarely a viable option for veterinary patients. - **Peritoneal dialysis:** Will reduce serum levels but is much less efficacious. - **Complexation:** Complexation of drug with either carbenicillin or ticarcillin (12-20 g/day in humans) is reportedly nearly as effective as hemodialysis.