| Amikacin Pharmacology |
| Amikacin |
| About Amikacin |
| Aminoglycoside Antibiotic. |
| Mechanism of Action of Amikacin |
| Amikacin exerts its bactericidal action against gram- negative organisms & some of gram positive organisms by inhibiting bacterial protein synthesis. The process involves 1. Penetration of bacterial cell membrane & binding directly to the bacterial ribosome, 2. Misleading of m-RNA codon by bacterial ribosome, 3. Formation of peptide chains with wrong amino acid sequence which gets incorporated into bacterial cell membrane and alters it`s permeability, 4. Bacterial cell lysis. It has broadest spectrum of activity among amino glycosides. |
| Pharmacokinets of Amikacin |
| Absorption: Poorly absorbed orally, Distribution: Distributed extracellularly. CSF penetration & intraocular penetration poor. Metabolism: Not metabolized, Excretion: Excreted mainly through urine. |
| Onset of Action for Amikacin |
| Within mins. |
| Duration of Action for Amikacin |
| 8 to 12 hours |
| Half Life of Amikacin |
| 2 to 3 hours |
| Side Effects of Amikacin |
| 1.Cochlear damage & hearing loss(ototoxicity) 2.Nephrotoxicity 3.Neuro muscular disorders |
| Contra-indications of Amikacin |
| 1.Hypersensitivity to the drug or other amino glycosides 2.Never use along with other nephrotoxic drugs |
| Special Precautions while taking Amikacin |
| 1.Renal impairment 2.Neuromuscular disorders 3. Auditory disorders |
| Pregnancy Related Information |
| Contraindicated. |
| Old Age Related Information |
| Use with caution. |
| Breast Feeding Related Information |
| Contraindicated. |
| Children Related Information |
| Use with caution. |
| Indications for Amikacin |
| 1.Infections caused by sensitive organisms like pseudomonas aeruginosa klebsiella, proteous etc. 2.Multi Drug Resistant Tuberculosis 3.Urinary Tract Infections |
| Interactions for Amikacin |
| Amphotericin B, Cisplatin, Cephalosporin, Vancomycin, Methoxyflurane, Frusemide, Bumetanide: Increased nephrotoxicity. Anaesthetics, Neuromuscular blocking agents (Tubocurarine): Risk of neuromuscular blockade and respiratory paralysis. Penicillin, Cephalosporins, Carbenicillin, Ticarcillin: Exert antibiotic synergism, especially useful in Pseudomonas infections. Loop diuretics: Concurrent use of these agents may increase the risk of respiratory paralysis and renal dysfunction. Lab Tests: Aminoglycoside serum levels: Guard against in-vitro inactivation of aminoglycosides by b-lactum antibiotics in patients on combination therapy. |
| Typical Dosage for Amikacin |
| Adults & Children: 15mg/kg/day in 1 to 3 doses; given intravenously or Intramuscularly Adults: 4 to 20 mg intrathecally as single dose. Tuberculosis: 15mg/kg/day 5 times weekly Urinary Tract Infections: 7.5 mg/kg/day Neonates: 10mg/kg intramuscularly or intravenously followed by 7.5 mg/kg twice Daily. |
| Schedule of Amikacin |
| H |
| Storage Requirements for Amikacin |
| Store in a cool dry place and protect from light. Keep out of reach of children. |
| Effects of Missed Dosage of Amikacin |
| Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose. |
| Effects of Overdose of Amikacin |
| An overdose results in Ototoxicity, nephrotoxicity, neuromuscular disorders & hypersensitivity manifestations. Treatment includes removal of drug by dialysis, &drug treatment with neostigmine, Ca, & Prednisolone. |