Drug Interaction:
Interacting drugs-summary
+ Polymyxin B
Aminoglycosides
concurrent use increase the risk of respiratory paralysis
and renal dysfunction
Nondepolarizing muscle relaxants
neuromuscular blockade enhanced
Polymyxin B +
Pancuronium
Parentral/intraperitoneal administration of high doses of certain antibiotics
produce neuromuscular block on its own. If used preoperatively
or in conjunction with pancuronium during surgery,unexpected
prolongation of neuromuscular block is a possibility
Vercuronium
parentral/intraperitoneal admininistration of of high doses of certain
antibiotics intensify or produce neuromuscular blockade on their
own. If used with vercuronium during surgery, consider the possibility of
unexpected prolongation of neuromuscular block
Pipercurinium
Parentral/Peritoneal administration of high doses of cetain antibitotics
intensify or produce neuromuscular blockade on their own. If used with
pipercuronium during surgery, consider prolongation of neuromuscular
block, a possiblity.
Adverse Reaction:
Nephrotoxic- Albuminuria, cylindruria, azotemia, rising blood levels without increase in dosage
Neurotoxic- facial flushing, dizziness progressing to ataxia, drowsiness, peripheral paresthesia, (circummoral and stoking-glove) apnea due to concurrent use of curariform muscle relaxants, other neurotoxic drugs or inadvertant
overdosage.
Meningeal irritation with intrathecal administration (eg. fever, headache, stiff neck ans increased cell count and protein in CSF)
Miscellaneous- drug fever, urticarial rash, severe pain or thrombophlebitis at injection sites
Contra-Indications:
Known allergy,/hypersens, myasthenia gravis
Special precautions:
Renal impairment, pregnancy
Monitoring- determinebaseline renal functioin prior to therapy. Frequenty monitor renal function and drug levels during therapy. The use of doses higher than those recommended is dangewrous and potentially fatal
Superinfection- use of antibiotics especially for prolonged therapy may result in bacterial or fungal overgrowth of nonsusceptible organisms. Such overgrowth may lead to secondary infection. Take appropiste measures if this occurs.
Warnings
Pregnancy- Safety for use during pregnancy has not been established
Dosages/ Overdosage Etc:
Indications:
Acute infections caused by pseudomonas. Topically and subconjuctively used in
treatment of eye infectons caused by susceptible strains of P. aeruginosa.
Dosage:
Adults and children- 15000 to 25000 units/kg/day in individuals with normal renal function Reduce this from 15OOO units downwards for individuals with renal impairment.
Infusions may be given every 12 hours, but daily dosage must not exceed 25000 units/kg/day.
Children below 2 years of age- 20000 units once daily,intrathecally for 3 to 4 days or 25000 units once every other day. Continue with a dose 25000 units once every other day for atleast 2 weeks after culture of the CSF are negative and glucose content has returned to normal.
Storage: Refrigerate and discard any unused portion after 72 hours.
Missed dose-
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1. If you miss a dose of this medicine, take it as soon as possible.
2. However, if it is almost time for next dose, skip the missed dose and go back to your regular dosing schedule.
3. Do not double doses.
Other Information:
Exacerbation of Myasthenia ( 2064 )
--
Myasthenia gravis-
The disease is characterised by weakness, and easy fatigability, it most frequently affects the occulomotor, facial,larygneal, pharyngeal, and respiratory muscles
Drugs causing adverse reactions- ( 388 )
1. Aminoglycosides
2.Polymixins
Pharmacology/ Pharmacokinetics:
Pharmacology:
Polymixin is a bactericidal against all gram-negative bacilli except the Proteus group; it increases the permeability of bactrial cell membranes.
Pharmacokinetics:
Polymixin is not absorbed from the normal GI tract. Since the drug loses 50% of its activity in the presence of serum, active blood levels are low. Tissue diffusion is poor, the drug does not pass the blood brain barrier into CSF. Drug is slowly excreted by kidneys
Interaction with Food:
Not available
Pregnancy and lactation:
Pregnancy: Safety for use during pregnancy has not been established.
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