Universal reference book for medicines
Product name: KANAMYCIN (KANAMYCIN)

Active substance: kanamycin

Type: Antibiotic of the aminoglycoside group

Manufacturer: BIOCHEMIK (Russia)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
Antibiotic of aminoglycoside group of broad spectrum of action, produced by Streptomyces kanamyceticus.
Has a bactericidal effect.
It is active against Mycobacterium tuberculosis, Gram-negative bacteria: Escherichia coli, Shigella spp., Salmonella spp., Proteus spp., Enterobacter spp., Klebsiella pneumoniae, Neisseria gonorrhoeae, Neisseria meningitidis;
Gram-positive cocci: Staphylococcus spp. (including strains that produce penicillinase).
Kanamycin is insensitive or resistant to Pseudomonas spp., Streptococcus spp.

Kanamycin is resistant to anaerobic bacteria, yeast, viruses and most protozoa.

PHARMACOKINETICS
When ingestion is practically not absorbed (through intact mucosa of the intestine, only about 1% is absorbed, large amounts can be absorbed through the damaged or ulcerated mucosa of the gastrointestinal tract), has a local effect.
The time to reach C max with the / m introduction is 0.5-1.5 h, after 30 min IV infusion - 30 min, after 60 min IV infusion - 15 min. C max after iv or in / m administration 7.5 mg / kg - 22 mcg / ml. Penetrates into the pleural cavity, lymphatic, synovial and peritoneal fluid, serum, bronchial secretion and bile. In bile, C max is reached after 6 hours. High concentrations are found in the urine; low concentrations - in bile, breast milk, watery moisture, bronchial secretion, sputum and cerebrospinal fluid. It penetrates well into all tissues of the body, where it accumulates intracellularly; high concentrations are noted in organs with good blood supply: lungs, liver, myocardium, spleen, and especially in the kidneys where it accumulates in the cortex, lower concentrations - in muscles, adipose tissue and bones. Normally, kanamycin does not pass through the BBB, but with inflammation of the meninges, the concentration of the drug in the cerebrospinal fluid reaches 30-60% of that in the plasma. Newborns develop higher concentrations in the cerebrospinal fluid than in adults.Penetrates through the placental barrier, is found in the fetal blood and amniotic fluid. V d in adults - 0.26 l / kg, in children - 0.2-0.4 l / kg, in newborns under 1 week and body weight less than 1.5 kg - up to 0.68 l / kg, at the age of 1 week and body weight more than 1.5 kg - up to 0.58 l / kg, in patients with cystic fibrosis - 0.3-0.39 l / kg. It is not metabolized.
T 1/2 in adults - 2-4 hours, in newborns - 5-8 hours, in older children - 2.5-4 hours. Final T 1/2 - more than 100 hours (release from intracellular depot).
After parenteral administration, it is excreted by the kidneys by glomerular filtration, mostly unchanged (70-95% is detected in the urine after 24 hours), with oral administration - with feces. T 1/2 in adults with renal dysfunction varies depending on the degree of impairment of the function up to 100 h, in patients with cystic fibrosis - 1-2 h, in patients with burns and hyperthermia T 1/2 may be shorter compared with the average values ​​due to increased clearance. It is excreted during hemodialysis (50% for 4-6 hours), peritoneal dialysis is less effective (25% for 48-72 hours).
INDICATIONS
For parenteral administration: infectious and inflammatory diseases caused by microorganisms sensitive to kanamycin;
tuberculosis (in case of resistance of mycobacteria to streptomycin and ftyvazid).
For oral administration: intestinal infections caused by sensitive microflora (including dysentery, dysentery bacteriocarrier, bacterial colitis, enterocolitis);
preparation for operations on the organs of the digestive tract.
For topical application in ophthalmology: conjunctivitis, blepharitis, keratitis, corneal ulcers.

DOSING MODE
With infections of non-tuberculous etiology, adults in / m or IV / drop (drip) are administered 500 mg every 8-12 hours, the daily dose is 1-1.5 g;
the maximum single dose is 1 g with an interval between administrations of 12 hours, the maximum daily dose is 2 g. The duration of treatment is 5-7 days. Children are given only in / m, the maximum daily dose is 15 mg / kg, the frequency of administration is 2-3 times / day.
When tuberculosis adults - 1 g 1 time / day, children - 15 mg / kg.
Enter for 6 days daily, on the 7th day - a break. The number of courses and the total duration of treatment are determined individually.
Kanamycin is injected into the cavity (pleural cavity, joint cavity) in the form of an aqueous solution, used as an aerosol and heat and moisture inhalations.

When carrying out peritoneal dialysis, 1-2 g is dissolved in 500 ml dialysate fluid.

In renal failure, the dose should be reduced or the intervals between administrations increased.

When administered orally, a single dose for adults is 0.5-1 g. For children, the dose is 50 mg / kg / day.
The frequency of application depends on the readings.
SIDE EFFECT
On the part of the digestive system: nausea, vomiting, diarrhea, impaired liver function (increased activity of hepatic transaminases, hyperbilirubinemia);
with prolonged ingestion - malabsorption syndrome (diarrhea, flatulence, light, foamy, oily stools).
On the part of the hematopoiesis system: anemia, leukopenia, granulocytopenia, thrombocytopenia.

From the central nervous system and peripheral nervous system: headache, drowsiness, weakness, neurotoxic effect (muscle twitching, sensation of numbness, tingling, paresthesia, epileptic seizures);
with parenteral administration (mainly with IV and intracavitary) neuromuscular blockade is possible.
From the senses: ototoxicity (ringing or feeling in the ears, hearing loss down to irreversible deafness), toxic effect on the vestibular apparatus (discoordination of movements, dizziness, nausea, vomiting), neuritis of the auditory nerve;
with topical application - the sensation of a foreign body in the eye (within 3-5 min), lacrimation, edema and hyperemia of the eyelids.
From the urinary system: increased or decreased frequency of urination, thirst, renal dysfunction (cylindruria, microhematuria, albuminuria).

Allergic reactions: skin rash, itching, skin hyperemia, fever, angioedema.

CONTRAINDICATIONS
Violation of the function of the liver, hearing loss (including as a result of defeat of the auditory nerve), obstruction of the gastrointestinal tract, increased sensitivity to kanamycin and other aminoglycosides in the anamnesis.

For parenteral administration: severe chronic renal failure with azotemia and uremia, neuritis of the VIII pair of CMN, pregnancy.

PREGNANCY AND LACTATION
Kanamycin is contraindicated in pregnancy.
If it is necessary to use kanamycin during lactation, the question of stopping breastfeeding should be resolved.
APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindication for parenteral administration is severe chronic renal failure with azotemia and uremia.

With caution and only for life indications to apply for kidney failure.

APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in the violation of liver function.

APPLICATION FOR CHILDREN
With caution and only for vital indications to use in premature infants, in children under the age of 1 month.

APPLICATION IN ELDERLY PATIENTS
With caution and only for life indications to use in elderly patients.

SPECIAL INSTRUCTIONS
Do not apply simultaneously or sequentially with other antibiotics that have ototoxic and nephrotoxic properties (including streptomycin, monomycin, neomycin, gentamicin, florimycin), together with diuretics (including furosemide, mannitol) and muscle relaxants (amplification and an increase in the duration of muscle relaxation).

With caution and only for life indications to use for myasthenia gravis, parkinsonism, botulism (aminoglycosides can cause a violation of neuromuscular transmission, which leads to further weakening of skeletal muscles), renal failure, in elderly patients.

If symptoms of side effects occur, kanamycin should be discontinued.

During the period of treatment it is recommended to monitor kidney function and conduct audiometry - at least once a week in the treatment of infections of non-tuberculous etiology and at least 1 time per month in the treatment of tuberculosis.

For IV or intrapleural administration, if signs of respiratory depression appear, Kanamycin should be discontinued and immediately injected into / into a solution of calcium chloride and a solution of prosorin with atropine.
If necessary, the patient is transferred to controlled breathing.
Patients with infectious inflammatory diseases of the urinary tract are advised to take an increased amount of fluid.
In the absence of positive clinical dynamics should be remembered the possibility of developing resistant microorganisms. In such cases, it is necessary to cancel treatment and begin appropriate therapy. In connection with the possibility of developing a neuromuscular blockade, iv administration of undiluted kanamycin is not recommended. When hepatic coma is used to prolong the inhibition of bacteria in the intestinal flora to reduce intoxication with ammonia.
With caution and only for vital indications to use in premature infants, in children under the age of 1 month.

DRUG INTERACTION
With the simultaneous use of beta-lactam antibiotics (cephalosporins, penicillins) in patients with severe chronic renal failure reduce the effect of aminoglycosides.

With the simultaneous use of nalidixic acid, polymyxin, cisplatin and vancomycin increase the risk of oto and nephrotoxicity.

With the simultaneous use of diuretics (especially furosemide), cephalosporins, penicillins, sulfonamides and NSAIDs, competing for active secretion in the nephron tubules, block the elimination of aminoglycosides, increase their concentration in serum, enhancing nephro- and neurotoxicity.

Cyclopropane increases the risk of developing apnea with intraperitoneal administration of kanamycin.

Parenteral administration of indomethacin increases the risk of toxic actions of aminoglycosides (an increase in T 1/2 and a decrease in clearance).

Kanamycin reduces the effect of antimiasthenic drugs, enhances the muscle relaxant effect of curare-like drugs, general anesthetics and polymyxins.

With simultaneous use of methoxyflurane, polymyxins for parenteral administration and other drugs that block neuromuscular transmission (halogenated hydrocarbons as inhalation anesthetics, opioid analgesics, transfusion of large amounts of blood with citrate preservatives), increase the risk of nephrotoxic action and respiratory arrest as a result of increased neuromuscular blockade).

Kanamycin is pharmaceutically incompatible with streptomycin, gentamicin, monomycin, penicillins, heparin, cephalosporins, capreomycin, amphotericin B, erythromycin, nitrofurantoin, viomycin.

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