네오마이신

동물 종별 용량

투여 경로

금기

• Hypersensitivity to aminoglycosides
• Intestinal obstruction (for oral use)
• Rabbits and hares (disrupts GI flora)
• Neonates (avoid oral use due to higher systemic absorption)
• Animals with a perforated tympanic membrane (eardrum)
• Concurrent use with other known ototoxic products
• Known hypersensitivity to aminoglycosides
• Pre-existing renal disease (for systemic use)
• Ruptured tympanic membrane (for otic preparations)

이상반응

• Nephrotoxicity (severe if given parenterally)
• Ototoxicity (irreversible, parenteral or rarely oral)
• Severe diarrhea
• Intestinal malabsorption
• GI superinfections (with chronic oral use)
• Ototoxicity (deafness)
• Vestibular toxicity (ataxia, head tilt, nystagmus)
• Local irritation or erythema at the application site
• Ototoxicity (vestibular and auditory)
• Nephrotoxicity
• Severe diarrhoea or malabsorption syndrome (oral use)
• Bacterial or fungal superinfections
• Local irritation (topical ophthalmic use)

약물 상호작용

• Digoxin · Oral neomycin may decrease digoxin absorption. In a small subset of patients who metabolize digoxin in the GI tract, neomycin may increase serum digoxin levels. · moderate
• Methotrexate · Absorption may be reduced by oral neomycin. · moderate
• Ototoxic or Nephrotoxic Drugs · Concurrent use increases the risk of additive toxicity, even with oral neomycin, and should be done with caution.
• Penicillin VK (oral) · Concurrent use may cause malabsorption of the penicillin.
• Warfarin · Oral neomycin may decrease vitamin K absorption from the gut, potentially increasing anticoagulant effects.
• Other ototoxic drugs (e.g., loop diuretics, other aminoglycosides) · Increased risk of cumulative ototoxicity (deafness and vestibular dysfunction) · major
• Potassium · Decreased absorption of potassium · minor
• Vitamin K · Decreased absorption of vitamin K · moderate
• Furosemide · Synergistic ototoxicity and nephrotoxicity · major

모니터링

• Clinical efficacy
• Systemic and GI adverse effects with prolonged use
• Renal function parameters (BUN, creatinine, urinalysis) if used parenterally
• Resolution of clinical signs of otitis
• Integrity of the tympanic membrane (via otoscopy)
• Hearing function and vestibular signs (head tilt, ataxia, nystagmus)
• Renal function (BUN, Creatinine, Urinalysis for casts/protein)
• Hearing and vestibular function (head tilt, nystagmus, ataxia)
• Gastrointestinal signs (diarrhoea)

과용량

Parenteral overdosage carries a high risk of severe **nephrotoxicity** and **ototoxicity**. Oral overdosage is less likely to cause systemic toxicity unless the gut wall is compromised, but can lead to severe diarrhea and malabsorption.