Orthopaedic Jobs

Amikacin/Amikin

 


 

- See:
      - aminoglycosides

- for short term Rx of serious infections from Gm Neg aerobes and penicillinase producing Staph;
- Adult: 15 mg/kg/24hr divided over q8-12 hours;
 - with clearance < 50 ml/min. give dose over 12-18hr;
 - w/ clearance < 30 give dose over 24-36 hr;
- Peds: 15-20 mg/kg/day q8hr (peak 20-30 and trough < 10)
- Not a first line drug, watch for Renal failure
- Is effective for aminoglycoside resistant bacteria;
- therapeutic levels: peak: 25-35; trough: 5-7;
- Avoid concurrent use with diuretics, nephrotoxic, neurotoxic;
- Good diffusion from blood into CSFonly with inflammation;
 - Ratio of CSF to Blood Level (%): Normal Meninges: 10-20;
 - Inflammed Meninges: 15-24;
- Dosing Regimens for Patients with Renal Insufficiency: (Dose for 70kg Adult {gm/dosing interval in hours}: CrCl: > 80: 0.35-0.7/8;
   CrCl: 50-79: 0.35-0.7/12-18; CrCl:30-49: 0.35-0.7/12-18; CrCl: 10-29: 0.35-0.7/24-36;
   - 98% of drug excreted in urine
- Supplement dose after Dialysis:
   Hemo: 4-5 mg/kg
   CAPD: 15-20 mg/Lit of dialysis
- Neuromuscular Blockade; Parental aminoglycosides:
- Will interact with Cephalothin (nephrotoxicity), Cis platin (nephrotoxicity, ototoxicity)Ether andNeuromuscular Blocking Agents (apnea or respiratory paralysis), Loop diuretics (ototoxicity), Pen in RF (Decr Aminoglyc effectiveness) vancomycin (nephrotoxicity), Oral anticoagulants (Increase PT); Peds: 15-22.5 mg/kg/24hr divided q8hr



A prospective study of long-term use of amikacin in a paediatrics department. Indications, administration, side-effects, bacterial isolates and resistance.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, November 30, 2012 1:30 pm