Aminoglycosides include Amikacin, gentamicin, Kanamycin, Netlmicin, Strptomycin, Tobramycin 

Interacting drugs- summary

+ Aminoglycosides

Loop diuretics incr auditory toxicity increased with concurrent use Hearing loss of varying degree occur 

+ Aminoglycosides

Loop diuretics incr auditory toxicity apperas to be increased with concurrent use Hearing loss of varying degree may occur

Increased incidence of ototoxicity when combined with ethacrynic acid Cephalosporin, hydrocortisone and indomethicin potentiate nephrotoxicity.

Potentiates neuromuscular blocking agents. Incompatible with amphotericin, some cephalosporines, erythromycin, heparin, high concetration of penicillines, and sodium carbonate. Synergy with ampicillin, benzyl penicillin and other Beta-lactum antibiotics.

Infections due to susecptible organisms Bacteraemia Respiratory tract tract inferctions Urinary tract infections 

Ototoxicity,nephrotoxicity and neuromuscular blockade (unmask or aggravate myasthenia gravis).

Allergic rashes and fever. Transcient elevation of serum billirubin and aminotransferases. Topical application: Local allergy.

History of hypersens or serious toxic reaction to aminoglycosides,renal impairment.

Special precautions:

Avoid concurrent use of diuretics, neuromuscular blocking agents,nephrotoxic & neurotoxic drugs.

Check renal, auditory & vestibular functions when high doses are reqd.

Infections due to susecptible organisms Bacteraemia Respiratory tract tract inferctions Urinary tract infections

Dosage:

Because of potential for toxicity, Serum level monitoring is recommended, when the drug is used in patients with impaired renal function, when doses in excess of 3mg/kg/day are used. May be given IM or IV.

Adults- for patients with serious infections and normal renal functions- 3mg/kg/day in 3 equal doses every 8 hours.

For life threatening infections - upto 5mg/kg/day in 3 or 4equal doses. Reduce dosage to 3mg/kg/day, as soon as clinically indicated.

Children- 6 to 7.5mg/kg/day(2 to 2.5mg/kg/ every 8 hours Infants and neonates- 7.5mg/kg/day(2.5mg/kg every 8 hours).

Premature or full term neonates(1 week or les than 1 week of age) - 5mg/kg/day(2.5mg/kg every 12 hours).

Refer Amikacin- aminoglycosides

1.Allergies- tell your doctor if you have ever had any unusual or allergic reaction to gentamycin or related products.
   Also tell your doctor if youare allergic to any other substances, such as foods, presrvatives or dyes.
   
2.Pregnancy - gentamicin topical preparations have not been reported to causebirth defects or problems in humans

3.Breast feeding- gentamicin topical preparations have not been reported to cause problems in nursing babies  

4 Children - not known to cause different side effects or problems thn it does in adults.

5. Elderly- this medicine is not expected to cause different side effects in older people than in younger adults.

9. Other medicines -

    Let your doctor know what other medicines you are taking, so that he can advice you accordingly.
   
    if you are taking non-prescription drugs or OTC medicines     
    
10. Missed dose -
    If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time  for the next dose, skip the missed dose. Do not double doses.

Pharmacology:
Aminoglycosideas are bactericidal antibiotics used primarily in the treatment of gram-negative infections. They irreversibly bind the 30S subunit of bacterial ribosomes, causing misreading of the genetic code. The ribosomes separate from messenger RNA , cell death ensues.

Pharmacokintics:
Absorption from the GI tract is very poor. Aminoglycosides are occassionally used orally for enteric infections. Aminoglycosides are widely distributed inextracellular fluids. Concentrations are found in bile, tissues, sputum, bronchial secretions and synovial, interstital , peritonieal fliuds.
Excretion is by glomerular foiltration, largely as unchanged drug.High urine levels are attained.