Amikacin Sulfate
Pronunciation: (am-ih-KAE-sin SULL-fate)Class: Aminoglycoside, parenteral
Trade Names:Amikin- Injection 250 mg/mL- Pediatric injection 50 mg/mL
Pharmacology
Inhibits production of bacterial protein, causing bacterial cell death.
Pharmacokinetics
Absorption
IMRapidly absorbed. C max is 12 to 21 mcg/mL (250 to 500 mg doses). T max is 1 h.
IVSingle doses (500 mg over 30 min) produced C max 38 mcg/mL.
Distribution
Vd is 24 L and protein binding is 0% to 11%. Crosses the placenta.
Elimination
IM98.2% is excreted in the urine as unchanged drug within 24 h.
IV94% is excreted in the urine within 24 h. T 1/2 is about 2 h. Serum Cl is 100 mL/min; renal Cl is 94 mL/min.
Special Populations
Renal Function ImpairmentRate of excretion is decreased and t 1/2 is prolonged. Dosage adjustment may be needed.
Indications and Usage
Treatment of infections caused by susceptible strains of microorganisms, especially gram-negative bacteria.
Contraindications
Generally not indicated for long-term therapy because of ototoxicity and nephrotoxicity.
Dosage and Administration
Adults, Children, and InfantsIV/IM 15 mg/kg (ideal body weight)/day in 2 or 3 divided doses. Treatment in heavier patients should not exceed 1.5 g/day.
Uncomplicated utisIV/IM 250 mg twice daily.
NewbornsIV/IM Loading dose of 10 mg/kg is recommended followed by 7.5 mg/kg q 12 h. Lower doses may be needed in first 2 wk of life.
Storage/Stability
Store at 20° to 25°C (68° to 77°F).
Drug Interactions
Drugs with nephrotoxic potential (eg, cephalosporins, enflurane, methoxyflurane, vancomycin)May increase risk of nephrotoxicity.
Loop diuretics (eg, furosemide)May increase risk of auditory toxicity.
Neuromuscular blocking agents (eg, tubocurarine)Amikacin may enhance effects of these agents.
Incompatibility
Do not mix with betalactam antibiotics (eg, carbenicillin, ticarcillin).
Laboratory Test Interactions
None well documented.
Adverse Reactions
EENT
Hearing loss; deafness; loss of balance.
Genitourinary
Oliguria; proteinuria; increased serum creatinine; urinary casts; red and white blood cells in urine; azotemia.
Miscellaneous
Decreased serum magnesium.
Precautions
WarningsNeurotoxicityManifests as both auditory and vestibular ototoxicity, and primarily occurs in patients with pre-existing renal damage or with prolonged therapy. Partial or total irreversible deafness may continue to develop after drug is stopped. Other features of neurotoxicity include paresthesias, twitching, and seizures. NephrotoxicityUsually reversible. Teratogenic in pregnancy. Renal and eighth nerve function closely monitored in patients with suspected renal dysfunction. Monitor peak and trough concentrations. Dosage adjustments required in renal function impairment. Neuromuscular blockade and respiratory paralysis have been reported following use of aminoglycosides. The possibility of these phenomena should be considered if aminoglycosides are administered by any route, especially in patients receiving anesthetics; neuromuscular blocking agents or in patients receiving massive transfusions of citrate-anticoagulated blood. |
Pregnancy
Category D .
Lactation
Undetermined.
Children
Cautious use is necessary in premature infants and newborns because of renal immaturity.
Renal Function
Dosage adjustment is needed in patients with this condition.
Patient Information
- Encourage patient to increase fluid intake to 2,000 to 3,000 mL/day, unless contraindicated.
- Warn patient that diarrhea and abdominal bloating are common side effects of antibiotics.
- Inform patient that improvement should be seen in 3 to 5 days.
- Instruct patient to report the following signs to health care provider: Hypersensitivity, tinnitus, vertigo, hearing loss.
- Teach patient to look for signs of renal failure and to notify health care provider immediately if these signs occur.
Copyright © 2009 Wolters Kluwer Health.
- Amikacin Prescribing Information (FDA)
- amikacin Concise Consumer Information (Cerner Multum)
- Amikacin MedFacts Consumer Leaflet (Wolters Kluwer)
