STREPTOMITSINA SULFAT (Streptomycini sulfas).

     Ethambutol-antibiotic formed in the radiant life mushrooms Streptomyces globisporus streptomycini or other related microbes.

     Organic authority : N-methyl a base glyukozamido- b -2 - streptozidostreptidin.

     Synonyms : Ampistrep, Diplostrep, Endostrep, Strepsulfat, Streptolin, Strepsulfat, Streptomycine sulfate, Streptaquaine, Strycin, Strysolin and others.

     Available in the form of sulphate.

     Streptomycin sulfate-powder or porous mass of white, or almost white, odourless, bitter taste; Gigroskopichen. The easily soluble in water, virtually nerastvorim in alcohol, chloroform and ether. Resistant to slightly Wednesday, but is easily destroyed in solutions of strong acids and alkalis in heat.

     Doses calculated by weight or unit of (ED); 1 ED is 1 µ g of streptomycin chemically pure reason.

     Streptomycin sulfate has a wide spectrum antimicrobial action. Antibiotics active against Mycobacteria tuberculosis, as well as most gram (Escherichia coli, wand Friedlander, wand influenza caused the plague, tularemia, brucellosis and some gramopolozhitelnyh (staphylococci) microorganisms; The less active against streptococcal pneumococcal. It operates on anaeroby, and rickettsiae viruses.

     Effective bactericidal streptomycin. The effect is the suppression of protein synthesis at ribosom in microbial cell.

     When ingestion streptomycin poorly absorbed and almost completely extracted through intestines. In intramuscular a well absorbed. The maximum concentration in plasma is after 1-2 h. After a single injection of therapeutic doses remains in the blood for 6 to 8 h. Write from the body mainly kidneys. In normal renal excretory function, the body does not accumulate in the reactivation. However, in violation of kidney function, the allocation of slowing down, the concentration in the body and can develop more adverse events (neurotoxic).

     Streptomycin sulfate used as the primary drug for the treatment of TB, mainly first detected pulmonary tuberculosis and tuberculosis losses elsewhere. Earlier cured patients, drug use them after laboratory sensitivity to it available to patients mycobacteria.

     Assign also streptomycin sulfate with chronic inflammatory processes in various sites caused by gram and gram micro-sensitive products : with pneumonia caused by klebsiellami (in combination with levomitsetinom), and plague and tularemia (in combination with tetracycline), brucellosis and endocarditis (in combined with other antibiotics).

     Applied streptomycin sulfate intramuscularly, as well as aerosols, intratrahealno, vnutrikavernozno (adults).

     In a single intramuscular dose for adults 0.5 to 1, 0 grams daily-1 yr highest daily dose-2 grams patients weighing less than 50 kg and those over 60 are 49 ychno no more than 0.75 grams per day .

     Daily intake for children and adolescents 15 to 20 mg per 1 kg of body weight, but not more than 0.5 grams a day-children and 1 g-adolescents.

     When treating tuberculosis, the daily dose is usually imposed once, when bad Portability can be divided into 2 introduction. The length of treatment depends on the shape and phase of the disease (3 months or more).

     When treating tuberculosis designate streptomycin sulfate in combination with rifampicin, isoniazid and other anti-TB drugs, with the exception of kanamycin and florimitsina.

     When treating infections netuberkuleznoy etiology daily dose give 3 - 4 reception at intervals of 6 to 8 hours Duration of treatment 7 to 10 days (not to exceed 14 days).

     For intramuscular medication dissolve in a sterile water for injection, isotonic sodium chloride solution, or 0,25 - 0,5% solution novocaine at 4 mL solvent at 1 g drug. Solution prepared before consumption.

     For patients with impaired renal excretory function streptomycin sulfate daily intake should be reduced. Thus, when endogenous creatinine clearance 50 to 60 mL / min should not exceed 0.5 g, 40 to 50 ml / min, maximum 0.4 g.

     Intratrahealno adults impose on the 0.5-1, 0 g 5-7 ml isotonic (sodium chloride solution, or 0.5% solution of novocaine 2 to 3 times or more per week.

     For use in aerosol form of adults - 0.5 1 0 g streptomycin sulfate dissolved in 4 - 5 ml (with teplovlazhnoy inhalation in the 25-100 ml) isotonic sodium chloride solution; Children designate the same dose as in the intramuscular introduction.

     Vnutrikavernozno product by introducing insufflyatsii a fine powder and instillyatsy 10% solution in a surgical patient one time per day dose of no more than 1 g (total) regardless of the number of landfills and how the introduction.

     For patients with hypertension, ischemic heart disease and treatment beginning of the path of small (up to 0.25 g) dose. With good endurance dose can be increased to normal.

     When treating streptomycin (and its derivatives) could experience different toxic and allergic reactions : drug fever, allergic dermatitis, and other phenomena, dizziness, headache, palpitation, hypertensive, hematuria; In connection with the suppression of intestinal microflora may have diarrhea. The most serious complications were defeated VIII pair skull nerves and related vestibular disorders and hearing impairment (ototoksichnost). With long-term use of large doses can develop deafness.

     Treatment streptomycin should be under close medical supervision; Before and systematically in the treatment, care should be taken as a pair of skulls VIII nerves, and the vestibular apparatus audible, kidney function, blood formula.

     In neurotoxic complications (headache, parestezii, hearing), the preparation and conduct Terms pathogenetic symptomatic therapy and, in particular, calcium designate pantotenat, thiamine, pyridoxine, piridoksalfosfat. If allergic reactions to drugs and stop the introduction of a desensibiliziruyuschuyu therapy. When signs of anaphylactic shock must be taken to remove the patient from the state.

     The rare but serious complications in parenteral is a neuro-muscular blockade conductivity up to stop breathing, especially in patients with neuro-muscular diseases (such as male) or aftercare period in the face of residual nedepolyarizuyuschih muscle Ward. When the first signs of neuro-muscular conductivity should introduce calcium chloride intravenously and subcutaneously Neostigmine. Doing patients, the patient is transferred to an artificial ventilation of the lungs.

     Contraindications : disease audible and vestibular apparatus associated with inflammation VIII couples and skull nerves and developed post-otonevrita; Severe cardiac insufficiency (stage III), and renal failure, a breach of cerebral circulation, obliteriruyuschy endarteriit, increased sensitivity to streptomycin, male.

     Streptomycin sulfate can be taken in conjunction with antibiotics, have ototoksicheskoe act [kanamycin, florimitsin (viomitsin) ristomitsin, gentamicin, monomitsin] and furosemide and kurarepodobnymi drugs.

     No mixing of streptomycin sulfate in the same syringe with the antibiotic penicillin, and some vegetable.

     Children babies and pregnant drug appoint only emergencies.

     Vnutrikavernoznoe introduction contraindicated in Bifida chest cavity in the ground and applied to a catheter localization caverns.

     Product : in bottles of 0.25, 0.5 and 1 year

     Storage : List B. When temperature is not above +25  C.

     Note.

     For those long-term contact with streptomycin (pharmacists, nurses, those who work the production of drugs), can develop contact dermatitis.

     To avoid this, follow the necessary precautions (work gloves, masks, protective glasses, etc.).

Materials allowed to copy only with the active hyperlink to the handbook of medicines