Kanamycinum

Kanamycinum – antibiotic drug of group of aminoglycosides.

Form of release and structure

Kanamycinum is released in the following dosage forms:

• Powder for preparation of solution for intravenous and intramuscular administration (in bottles on 10 ml, on 1, 10, 50 bottles in a cardboard pack);
• Powder for preparation of solution for intramuscular introduction (in bottles on 10 ml, on 1, 5, 10, 50 bottles in a cardboard pack);
• Powder for preparation of solution for injections (in bottles, on 1, 10, 50 bottles in a cardboard pack).

Active agent is a part of 1 bottle: Kanamycinum – 500 or 1000 mg (in the form of monosulphate).

Indications to use

• Infectious and inflammatory diseases of a respiratory organs, including pneumonia, lung abscess, a pleura empyema;
• Heavy it is purulent - septic diseases, including peritonitis, meningitis, sepsis, a septic endocarditis;
• The purulent complications developing in the postoperative period;
• Infections of urinary tract and kidneys, including cystitis, pyelonephritis, an urethritis;
• The pulmonary tuberculosis and tubercular diseases of other bodies caused by the tuberculosis mycobacteria showing stability to antitubercular medicines I and II of a row and other antitubercular drugs except a florimitsin;
• The infected burns and other diseases caused by preferential gram-negative microorganisms (Klebsiella pneumonia, E. coli, Serratia, Enterobacter aerogenes, Salmonella, Proteus spp., Shigella), showing other antibiotic drugs resistance, or associations of gram-negative and gram-positive activators.

Contraindications

• Neuritis of the VIII couple of cranial nerves;
• Heavy chronic renal failure with an azotemia and uraemia;
• Pregnancy;
• Hypersensitivity to drug components (including to other aminoglycosides in the anamnesis).

The feeding women should appoint Kanamycinum with care, to elderly patients, premature children and children is younger than 1 month, and also the patient with a myasthenia, parkinsonism, a renal failure and botulism (aminoglycosides can lead to neuromuscular transmission disturbance that will cause further weakening of skeletal muscles).

Route of administration and dosage

Kanamycinum is applied intramusculary, intravenously (kapelno), in-band.

At intravenous administration (kapelno) a single dose (500 mg) it is necessary to dissolve 5% of solution of a dextrose in 200 ml. The drug is administered with a speed of 60-80 thaws a minute.

At treatment of infections of not tubercular etiology the adult single dose makes 500 mg, daily – 1000-1500 mg (each 8-12 hours on 500 mg). The highest daily dose – 2000 mg. Duration of a therapeutic course – 5-7 days. To children Kanamycinum is entered only intramusculary on 50 mg/kg a day. Premature and to children of the first month of life drug is appointed only according to vital indications.

At treatment of tuberculosis Kanamycinum is applied intramusculary. The mode of dosing is defined by age:

• Adults: once a day on 1000 mg or 2 times a day on 500 mg;
• Children: on 15-20 mg/kg a day (as much as possible – 500-750 mg a day).

Every seventh day of treatment should be done a break.

Into cavities (pleural, belly, joint) Kanamycinum is entered for washings. A single dose – 10-50 ml of 0,25% of aqueous solution.

Intraperitoneally enter 2,5% of solution on 500 mg.

When carrying out peritoneal dialysis it is necessary to dissolve 1000-2000 mg of Kanamycinum in 500 ml of the dialyzing liquid.

In the form of heatwet inhalations and an aerosol (at a temperature of solution of 35-40 °C) Kanamycinum is applied at treatment of infections of respiratory tract of not tubercular etiology and a pulmonary tuberculosis. For this purpose 250-500 mg of drug should be dissolved in 3-5 ml of the distilled water or 0,9% of solution of sodium chloride. Frequency rate of introduction – 2 times a day. Apply the following mode of dosing (a single/daily dose):

• Adults: 500/500-1000 mg;
• Children: 5/15 mg/kg.

Duration of therapy is defined by indications: acute diseases – 7 days, chronic pneumonia of-15-20 days, a pulmonary tuberculosis – 30 days and more.

The scheme of introduction for patients with a renal failure should be adjusted by decrease in doses or increase in breaks between introductions (it is recommended to apply the following formula to calculation: a break between introductions in hours = the content of creatinine in a blood plasma (mg / 100 ml) × 9).

The initial dose of Kanamycinum is calculated taking into account body weight (a dose, mg = body weight × 7). For calculation of the subsequent doses the initial dose needs to be divided into the content of creatinine in blood serum (mg / 100 ml).

Frequency rate of use – 2-3 times a day. In days of a hemodialysis after its carrying out it is necessary to enter an additional single dose of drug.

To avoid overdose, it is recommended to control periodically concentration of Kanamycinum in the patient's blood.

Side effects

During use of Kanamycinum development of the following side effects is possible:

• Urinary system: nephrotoxicity – functional disturbances of kidneys (thirst, increase or decrease in frequency of an urination, a microhematuria, a cylindruria, an albuminuria);
• Nervous system: weakness, drowsiness, a headache, neurotoxic disturbances (epileptic seizures, feeling of a pricking and numbness, twitching of muscles, paresthesias), disturbance of neuromuscular transfer is possible;
• Digestive tract: functional disturbances of a liver (hyperbilirubinemia, increase in activity of hepatic transaminases), nausea, diarrhea, vomiting;
• Sense bodys: ototoxicity (feeling of a mortgaging or a ring in ears, a hearing impairment up to irreversible deafness), toxic impact on a vestibular mechanism (dizziness, a diskoordination of movements, vomiting and nausea);
• Bodies of a hemopoiesis: thrombocytopenia, leukopenia, anemia, granulocytopenia;
• Allergic reactions: itch, skin rash, fever, dermahemia, Quincke's edema.

Special instructions

During use of Kanamycinum follows at least 1 time in 7 days to control function of a vestibular mechanism, acoustical nerve and kidneys.

The probability of development of nephrotoxicity is higher at patients with functional disturbances of kidneys, and also at use of high doses of drug or at long therapy (such patient daily control of function of kidneys can be required).

At unsatisfactory results of audiometric tests it is necessary to reduce a dose of Kanamycinum or to stop its use.

Patients with infectious and inflammatory diseases of urinary tract should accept the increased amount of liquid.

Aminoglycosides get into breast milk in a small amount (the complications connected using drug at babies were not registered as active agent is badly soaked up from digestive tract).

In the absence of positive clinical dynamics it is necessary to consider a possibility of development of resistance of microorganisms. In these cases it is necessary to cancel drug and to begin performing the corresponding therapy.

Medicinal interaction

Kanamycinum pharmaceutical is incompatible with gentamycin, streptomycin, penicillin, Monomycinum, heparin, kapreomitsiny, cephalosporins, erythromycin, Amphotericinum In and nitrofurantoin.

At simultaneous use of Kanamycinum with some medicines there can be undesirable effects:

• Polymyxins, Acidum nalidixicum, Vancomycinum, Cisplatinum: increase in probability of development nefro-and ototoxicity;
• Penicillin, cephalosporins, diuretics (especially furosemide), streptocides, non-steroidal anti-inflammatory drugs: blocking of elimination of aminoglycosides, increase in their concentration in blood serum that leads to strengthening nefro-and a neurotoxicity;
• Indometacin (parenteral administration): increase in risk of development of toxic action of Kanamycinum (increase _{in T1/2} (elimination half-life) and decrease in clearance);
• Anti-myasthenic medicines: decrease in their effect;
• Kurarepodobny drugs, general anesthetics and polymyxins: strengthening of their myorelaxation action;
• Polymyxins for parenteral administration, метоксифлуран and other medicines blocking neuromuscular transmission (opioid analgetics, halogenated hydrocarbons as drugs for inhalation anesthesia), transfusion of large amounts of blood with citrate preservatives: increase in risk of an apnoea (because of strengthening of neuromuscular blockade).

Terms and storage conditions

To store in protected from light, the place, unavailable to children, at a temperature up to 25 °C.

Period of validity – 2 years.