Neomycin (When ATH D06AX04)
When ATH:
D06AX04
Characteristic.
Antibiotics aminoglycoside I generation. It is a complex of antibiotics neomycin (A neomycin, neomycin B, With neomycin), formed in the process of life radiant fungus (actinomycetes) Streptomyces fradiae or related microorganisms. White or off-white crystalline powder, almost odorless; easily soluble in water, very little - in alcohol, practically insoluble in organic solvents; hygroscopic. Available in the form of neomycin sulfate.
Pharmacological action.
Broad-spectrum antibacterial, bactericide.
Application.
Infectious-inflammatory diseases of the skin, due to the sensitive microflora, incl. pyoderma, infected eczema, infitsirovannaya ulcer, infected wounds.
Contraindications.
Hypersensitivity (incl. other aminoglycosides).
Restrictions apply.
If necessary, use over large areas of skin (the risk of ototoxicity, especially in children, the elderly and patients with impaired renal function) - Defeated VIII pair of cranial nerves, myasthenia, Parkinson's syndrome, botulism, degidratatsiya, renal failure, pregnancy and breastfeeding.
Pregnancy and breast-feeding.
Pregnant application is permitted only for health. When systemic absorption may cause GRT- and nefrotoksicheskoe effect of fruit. Unknown, Do neomycin penetrates into breast milk.
Side effects.
Allergic reactions: contact dermatitis (itch, rash, hyperemia, puffiness, skin irritation), suction with a large surface possible systemic effects.
Systemic reactions
From the digestive tract: nausea, vomiting, increase in liver transaminases, giperʙiliruʙinemija, hyperptyalism, stomatitis.
Cardio-vascular system and blood (hematopoiesis, hemostasis): reduction or increase in blood pressure, anemia, leukopenia, granulocytopenia, reticulocytopenia, thrombocytopenia.
From the nervous system and sensory organs: neurotoxic effects (clonus, paraesthesia, benumbed sensation, seizures); rarely - neuromuscular blockade (difficulty breathing, weakness), headache, drowsiness, ototoxicity - noise or sensation in the ears laying, hearing loss, vestibular and labyrinth disorders (Instability and unsteadiness of gait, dizziness, nausea, vomiting), irreversible deafness.
With the genitourinary system: nephrotoxicity - increase or decrease the frequency of urination, thirst, oliguria or polyuria, the appearance of the precipitate in the urine, increasing the concentration of urea and creatinine in plasma, proteinuria.
Allergic reactions: skin rash, itch, fever, angioedema, eozinofilija.
Other: hypocalcemia, kaliopenia, gipomagniemiya, giponatriemiya, hyperthermia, development of superinfection, weight loss.
Cooperation.
When systemic absorption increases the effect of indirect anticoagulants (reduces the production of vitamin K by intestinal flora), reduces -serdechnyh glycosides, ftoruracila, methotrexate, fenoksimetilpenicillina, Vitamins A and B12, chenodeoxycholic acid (increases the excretion of cholesterol in bile), oral contraceptives.
Pharmaceutically incompatible with other drugs. Nesovmestim with streptomicinom, kanamycin, monomicinom, gentamicin, viomycin and other GTR- and nephrotoxic antibiotics (It increases the risk of toxic complications). Funds, blocking neuromuscular transmission, th- and nephrotoxic drugs, incl. capreomycin or other aminoglycosides, Polymyxin, inhaled general anesthetics (incl. halogenated hydrocarbons), citrate preservatives transfusion of large amounts of stored blood increases the risk of dis-, nephrotoxicity, and the blockade of neuromuscular transmission.
Overdose.
Symptoms: decrease neuromuscular (respiratory arrest).
Treatment: adult I / administered anticholinesterase drugs (Proserinum), as well as calcium supplements (calcium chloride 10% 5-10 Ml, kalytsiya gluconate 10% 5-10 Ml). Before the introduction of pre-neostigmine in / atropine at a dose of 0.5-0.7 mg, 1.5-2 minutes after increased heart rate in / injected 1,5 mg (3 ml 0,05% solution) Prozerina. If the effect of this dose is not sufficient, re-enter the same dose of neostigmine (the appearance of bradycardia make additional injection of atropine). Children are calcium supplements. In severe cases, respiratory depression - AV. It may be displayed by hemodialysis (more effective) and peritoneal dyalyza.
Dosing and Administration.
Locally. Apply to affected skin 1-3 times (to 5 time) per day. The maximum single (daily) dose 0,5% ointment - 25-50 g (50100 g), to 2% - 5.10 g (10-20 G) respectively.
Do not apply more 5 Nights.
Precautions.
Currently neomycin because of the high toxicity (neuro-, nephrotoxicity- and ototoxicity) It has limited utility. Multiplicity method and topical dosage forms depends on the quantitative and its content of neomycin.
Avoid prolonged use of neomycin because of the risk of skin sensitization and increased cross-sensitivity to other aminoglycosides.
