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Attention! The information is provided for informational purposes only. This instruction should not be used as a guide to self-medication. The need for prescription, methods and doses of the drug are determined exclusively by the attending physician.

general characteristics

International and chemical name: kanamycin;

Compound: 1 bottle contains sterile kanamycin acid sulfate in terms of kanamycin 1.0 g.

Basic physical and chemical properties: the powder is white or almost white, hygroscopic, the drug can stick to the walls of the bottle;

Pharmacotherapeutic group

Antimicrobial agents for systemic use. Aminoglycosides.

Pharmacodynamics

Pharmacokinetics: When administered intramuscularly, it quickly enters the bloodstream and the therapeutic concentration is maintained for 8 to 12 hours. Penetrates into the pleural cavity, synovial fluid, bronchial secretions, bile (Bile- a secretion produced by glandular cells of the liver. Contains water, bile salts, pigments, cholesterol, enzymes. Promotes the breakdown and absorption of fats, enhances peristalsis. The human liver secretes up to 2 liters of bile per day. Preparations of bile and bile acids are used as choleretic agents (allochol, decholin, etc.)), through the placental barrier. Normally, kanamycin does not pass through blood-brain barrier (Blood-brain barrier- a barrier formed by the endothelium of brain vessels: between endothelial cells there are no intercellular spaces characteristic of other vessels. As a result, water-soluble polar substances do not penetrate into the brain from the blood), however, with inflammation of the meninges, its concentration in the cerebrospinal fluid reaches 30 - 60% of that in plasma (Plasma- the liquid part of the blood, which contains formed elements (erythrocytes, leukocytes, platelets). Various diseases (rheumatism, diabetes mellitus, etc.) are diagnosed based on changes in the composition of blood plasma. Medicines are prepared from blood plasma) blood.
It is excreted by the kidneys within 24 - 48 hours.

Method of use and dosage

Before using Kanamycin-KMP, the sensitivity of the pathogen to it should be determined.
Kanamycin-KMP is prescribed only intramuscularly.

For children: For children with infections of non-tuberculous etiology up to 1 year of age (in exceptional cases), the drug is prescribed in an average daily dose of 0.1 g; from 1 year to 5 years - 0.1 - 0.3 g; over 5 years - 0.3 - 0.5 g; the maximum daily dose is 15 mg/kg, the frequency of administration is 2 - 3 times a day.
The duration of the course of treatment is 5 - 7 days.

For adults, a single dose for the treatment of infections of non-tuberculous etiology is 0.5 g every 8 - 12 hours, the daily dose is 1 - 1.5 g; maximum single dose - 1.0 g with an interval between administrations of 12 hours, maximum daily dose - 2 g. Duration of treatment - 5 - 7 days.
A solution for intramuscular administration is prepared ex tempore by adding 4 ml of sterile water to the contents of the bottle (1.0 g) for injections (Injection- injection, subcutaneous, intramuscular, intravenous, etc. introduction into the tissues (vessels) of the body of small quantities of solutions (mainly medicines)) or 0.25 - 0.5% solution of novocaine, injected deep into the upper outer quadrant of the buttock no more than 2 - 3 times a day.
For the treatment of tuberculosis, adults are prescribed 1.0 g once a day, children - 15 mg/kg once a day. Treatment lasts 1 month or more (administered for 6 days daily, on the 7th day - a break).

Side effects

Nausea, vomiting, diarrhea (Diarrhea- frequent discharge of liquid feces, associated with accelerated passage of intestinal contents due to increased peristalsis, impaired absorption of water in the large intestine and the release of a significant amount of inflammatory secretion by the intestinal wall), allergic reactions, neuromuscular blockade (Blockade- slowing down or interrupting the conduction of electrical impulses in any part of the conduction system of the heart or myocardium), paresthesia (Paresthesia(from the Greek par - near, past, outside and isthesis - feeling, sensation) - an unusual sensation of numbness of the skin, “crawling goosebumps”, which occurs without external influence or under the influence of some mechanical factors (compression of a nerve, vessel). Paresthesia can be a manifestation of diseases of the peripheral nerves, less often - of the sensory centers of the spinal cord or brain), dysbacteriosis (Dysbacteriosis- a change in the species composition and quantitative ratios of the normal microflora of an organ (mainly the intestines), accompanied by the development of microbes atypical for it. Occurs under the influence of competing microorganisms, antibiotics, changes in nutrition); possible irritation at the injection site. With long-term use, the development of auditory neuritis and nephrotoxic reactions (microhematuria, albuminuria, cylindruria) is possible.

Indications for use

Kanamycin-KMP is used for the treatment of severe purulent-septic diseases (sepsis, meningitis, peritonitis, septic endocarditis (Endocarditis– inflammation of the endocardium)), infectious and inflammatory diseases of the respiratory system (pneumonia, pleural empyema, abscess (Abscess– limited purulent inflammation of tissues with the formation of a purulent cavity. An abscess can form independently or as a complication of another disease (peritonitis, pneumonia, trauma, etc.)) lungs), kidney and urinary tract infections, purulent complications in the postoperative period, infected burns, tuberculosis (in the case of mycobacterium resistance to streptomycin and ftivazide) and other diseases caused predominantly by gram-negative microorganisms sensitive to kanamycin.

Interaction with other drugs

The simultaneous use of Kanamycin-KMP with streptomycin, monomycin, neomycin, gentamicin, florimycin and other oto- and nephrotoxic drugs is not recommended. Kanamycin-KMP should not be combined with furosemide and other diuretics.

Overdose

Possible in case of overdose toxic (Toxic reactions. At parenteral (Parenteral- dosage forms administered, bypassing the gastrointestinal tract, by applying to the skin and mucous membranes of the body\; by injection into the vascular bed (artery, vein), under the skin or muscle\; by inhalation, inhalation (see Enteral)) administration, the possibility of neuromuscular blockade (curare-like effect) should be taken into account.
Treatment: for toxic reactions - peritoneal dialysis (Peritoneal dialysis- is based on the use of peritoneum - a thin and rich in blood vessels natural membrane that covers the intestines in the abdominal cavity. The peritoneum acts as a dialyser. First, a special solution, dialysate, is injected into the abdominal cavity for several hours. The dialysate is administered through a thin tube - a catheter, which is installed in the lower part of the abdominal cavity. Inserting a catheter is a minor surgical procedure. Gradually, waste products of the body pass through the peritoneum from the blood into the dialysate. The dialysate (which now contains toxins) is then removed from the abdominal cavity and fresh dialysate is injected. When not in use, the catheter is closed and hidden under clothing. Patients typically use this dialysis method at home or at work. A designated area for dialysis should be set aside in the patient's home. The patient should not miss dialysis exchanges. The most commonly used peritoneal dialysis techniques are: CAPD (continuous ambulatory peritoneal dialysis): dialysate exchanges are performed in the morning, then at lunch and in the afternoon. The last dialysate change is performed before bedtime. Each exchange procedure takes about 30 minutes. APD (automatic peritoneal dialysis): during the night, a special device - a cycler - repeatedly replaces the dialysate, filling and emptying the peritoneal cavity while the patient sleeps) or hemodialysis (Hemodialysis- a method of extrarenal blood purification for acute and chronic renal failure. During hemodialysis, toxic metabolic products are removed from the body, disturbances in water and electrolyte balance are normalized). And in case of blockade and respiratory depression, prozerin with atropine is administered; If necessary, artificial ventilation is indicated.

Features of use

Before using the drug, you need to pay attention to the condition of your kidneys.
Treatment should be carried out under audiometric monitoring and periodic monitoring of the functional state of the kidneys.
During pregnancy, lactation (Lactation- secretion of milk from the mammary gland), as well as in children of the first year of life, the use of the drug is allowed only for health reasons.
For elderly people, Kanamycin-KMP should be prescribed only if it is impossible to use less toxic (toxic- poisonous, harmful to the body) antibiotics. If the drug is used, the recommended dose should not be exceeded, and renal function should be carefully monitored during treatment.

General Product Information

Storage conditions and period: Store in a place protected from light, at a temperature not exceeding + 20 °C.
Shelf life - 3 years.
Keep out of the reach of children.

Terms of sale: On prescription.

Package: 1.0 g in bottles.

Manufacturer.Arterium Corporation.

Location. 01032, Ukraine, Kiev, st. Saksagansky, 139.

Website. www.arterium.ua

This material is presented in free form on the basis of the official instructions for medical use of the drug.

Collapse

Kanamycin is known for its toxicity and high effectiveness against tuberculosis, and therefore was used for a long time before the development of safer drugs. The powder is used in solutions for injections and droppers, as well as for inhalation for lung damage.

What is kanamycin?

Kanamycin is a drug based on an antibacterial component from the fungus Streptomyces kanamyceticus. It belongs to the first generation aminoglycosides and is used as a second-line drug in the treatment of tuberculosis. The composition contains components called kanamycins A, B and C.

The drug affects gram-positive and gram-negative, as well as acid-resistant strains. Kanamycin is effective against M. tuberculesis that do not respond to therapy with streptomycin, isoniazid, erythromycin, chloramphenicol and tetracycline. Has cross-resistance with neomycinam. Ineffective against anaerobes, viruses, fungi.

Properties

The mechanism of action of the drug is based on the fact that when the membrane structure is destroyed, the bacterial cell dies. The substance penetrates the cell membrane and binds to receptor proteins, which prevents messenger RNA from reading information from the ribosome. The drug disrupts the production of bacterial protein, and polyribosomes disintegrate and stop protein synthesis.

The drug is prescribed against Escherichia coli, Proteus, Klebsiella, Salmonella, Shigella, Haemophilus influenzae, Yersinia, Neisseria, Staphylococcus (but not against methyllicine-resistant). Does not work against pseudomonas, streptococcus, yeast.

The disadvantage of kanamycin is the rapid formation of resistance. Therefore, the drug is prescribed if mycobacteria do not respond to other 1st and 2nd line drugs.

Release forms

Varieties of the drug are used in therapy:

1. Tablets are made on the basis of kanamycin monosulfate - a white, tasteless powder, easily soluble in water (not in alcohols and alkalis).
2. The substance of kanamycin sulfate should be diluted with a sterile solvent for injections and droppers.

They are produced in bottles of 0.5 and 1 g of the substance for injection. The ampoule form of release of 5-10 ml includes 0.25 and 0.5 g of the drug. Tablets contain 0.125 and 0.25 g of kanamycin monosulfate.

Antiseptic sponge with kanamycin contains 37500 IU of active substance, 1.5 mg of nitrofural. Used for burns, injuries, bleeding, trophic ulcers, post-surgical complications.

Indications for use

Main indications for use – bacterial infection:

1. Tuberculosis and other infections in the bile ducts, respiratory system, skin, muscles, fascia, bones and joints, urinary tract in the form of injections or droppers. The drug is used for sepsis, meningitis, and nosocomial infections.
2. Infection of the gastrointestinal tract: intestinal lavage for colitis, in the preoperative period, for hepatic coma and encephalopathy is administered orally.
3. For eye infections, films with the drug are used.

1. For adults – 0.5 g one-time dose up to 1.0-1.5 g per day with an interval of 8-12 hours into a vein or intramuscularly. Maximum 2 g with an interval of 12 hours. Course for 5-7 days.
2. For children - intramuscular injections of no more than 0.1 g per day up to one year, up to 0.3 g - up to 5 years, up to 0.5 g - from 5 years. The dose of no more than 15 mg/kg per day is divided into 2-3 times.

Instructions for use: canthamicin monosulfate tablets are used for intestinal infections and preoperative preparation. Take 0.5-0.75 g one-time, but not more than 3 g in total per day. Children - 50 mg/kg with a possible increase to 75 mg per kg, and the resulting dose is divided into 4-6 doses. Therapy continues for 10 days. During sanitation, 1 g of canthamicin is administered every 4 hours, maximum 6 g per day.

Contraindications

The drug is prohibited in the following cases:

• patients with sensitivity to aminoglycosides;
• with a history of neuritis of the vestibulocochlear nerve;
• with myasthenia;
• in Parkinson's disease.

Contraindications are: intestinal obstruction, severe stages of kidney disease.

The antibiotic kanamycin should not be taken during pregnancy and breastfeeding.

How to take it correctly for tuberculosis?

In the treatment of tuberculosis, kanamycin sulfate is rarely chosen: when mycobacteria are resistant to 1st and 2nd line drugs, except florimycin. The substance is administered by intramuscular injection. If this is not possible, then drip into a vein or into an organ cavity. Spraying into the respiratory tract is used.

Instructions for use: injections are performed intramuscularly. Dissolves 0.5 or 1 g of the substance in 2-4 ml of sterile water or novocaine. For droppers, ready-made solutions are added to saline solution of sodium chloride and glucose - 200 ml.

The administered kanamycin immediately enters the bloodstream and acts for 8-12 hours. The drug penetrates the pleura, joint fluids, bronchial secretions, bile and through the placenta. The substance does not overcome the barrier of the central nervous system, but against the background of inflammation of the cerebral membranes, up to 30-60% of the plasma level enters the cerebrospinal fluid. The drug is excreted completely by the kidneys after 24-48 hours.

Before using kanamycin, the sensitivity of the tuberculosis pathogen must be determined.

For children

The pediatric dose of anti-tuberculosis therapy with canthamicin is up to 15 mg/kg. The dosage when sprayed into the respiratory tract is not higher than 5 mg/kg. The medicine spray is also used 6 times a week with a one-day break. The number of inhalations depends on the stage and duration of infection.

For adults

The daily dose for anti-tuberculosis therapy is 1 g once. The treatment regimen involves a six-day administration of the drug with a break every seventh day. The number of cycles and duration of therapy depends on the stage of the disease and its course.

For pulmonary empyema, 50 ml of an aqueous solution with a concentration of 0.25% is required into the pleural cavity. For peritoneal dialysis, dissolves 1-2 g of powder per 500 ml of solutions.

A spray based on 0.25-0.5 g of canthamicin powder diluted in 3-5 ml of isotonic sodium chloride solution is sprayed. Repeat twice a day without exceeding the amount of 0.5-1 g for adults, 15 mg/kg for children. In the acute phase of the disease, the procedures are carried out for 7 days, in the chronic phase - 20 days, in tuberculosis - more than a month.

Kanamycin is rarely prescribed to elderly patients unless there is no alternative to choosing safer antibiotics. It is recommended to strictly adhere to dosages and check kidney function.

Side effects

Therapy should be supervised by a physician. The administration of medication sometimes leads to complications:

1. Inflammation of the vestibulocochlear nerve is why hearing tests are carried out. If tinnitus occurs, the drug is discontinued. The drug is prescribed to young children with extreme caution.
2. Against the background of toxicity, it provokes the appearance of red blood cells, albumin and cylindrical cells in the urine. The instructions for use recommend taking the test once a week. If signs of kidney toxicity appear, the drug is discontinued.
3. There is a risk of musculoskeletal blockades. In case of respiratory depression, proserin with artropine is immediately administered. To minimize side effects, use calcium pantothenate and ATP solution.
4. Kanamycin tablets can cause dyspepsia.

Due to toxicity, the drug is not prescribed simultaneously with streptomycin, neomycin, and not earlier than 12 days after antibiotic therapy.

Premature and full-term newborns, pregnant women are prescribed the drug if there is a threat to life.

Storage

Store ampoules, tablets and vials of kanamycin in a dry place, protected from light, at a temperature of 25 degrees.

How to distinguish a fake?

The drug is affordable, and counterfeits are rare. When treating tuberculosis, it is rarely prescribed, but is more often purchased for aquarium fish with mycobacteriosis. Kanamycin is a white or almost white powder in an ampoule; sticking to the walls is allowed. The substance is easily soluble in water.

Analogues

In the group of aminoglycosides, more modern and safe analogues are distinguished: third generation amikacin, as well as second generation gentomycin. Among antibiotics of other groups, ofloxacin has a similar effect.

Price in pharmacy

The price of kanamycin in ampoules ranges from 15-20 rubles, packages of 10 and 50 pieces are sold. In tablet form, the drug costs from 10 rubles.

Conclusion

The drug kanamycin belongs to the first generation aminoglycosides, which are highly toxic. Serious side effects limit the choice of drug in the treatment of tuberculosis.

Kanamycin (acidic) sulfate (kanamycin)

Composition and release form of the drug

Powder for the preparation of a solution for intravenous and intramuscular administration white or almost white, hygroscopic.

Solvent (if included): water d/i - 2 ml or 5 ml.

1 g - glass bottles (1) - cardboard packs.
1 g - glass bottles (5) - cardboard boxes (for hospitals).
1 g - glass bottles (10) - cardboard boxes (for hospitals).
1 g - glass bottles (25) - cardboard boxes (for hospitals).
1 g - glass bottles (50) - cardboard boxes (for hospitals).
1 g - glass bottles (100) - cardboard boxes (for hospitals).
1 g - glass bottles (1) complete with solvent (amp. 5 ml) - contour cell packaging (1) - cardboard packs.

pharmachologic effect

Broad-spectrum aminoglycoside antibiotic produced by Streptomyces kanamyceticus. Has a bactericidal effect.

Active against Mycobacterium tuberculosis, gram-negative bacteria: Escherichia coli, Shigella spp., Salmonella spp., Proteus spp., Enterobacter spp., Klebsiella pneumoniae, Neisseria gonorrhoeae, Neisseria meningitidis; gram-positive cocci: Staphylococcus spp. (including strains producing penicillinase).

Pseudomonas spp., Streptococcus spp. are insensitive or resistant to kanamycin.

Anaerobic bacteria, yeast, viruses and most protozoa are resistant to kanamycin.

Pharmacokinetics

When taken orally, it is practically not absorbed (only about 1% is absorbed through the intact intestinal mucosa; large quantities can be absorbed through the damaged or ulcerated mucous membrane of the gastrointestinal tract), has a local effect. The time to reach Cmax with intramuscular administration is 0.5-1.5 hours, after 30 minutes of intravenous infusion - 30 minutes, after 60 minutes of intravenous infusion - 15 minutes. Cmax after IV or IM administration is 7.5 mg/kg – 22 mcg/ml. Penetrates into the pleural cavity, lymphatic, synovial and peritoneal fluids, blood serum, bronchial secretions and bile. In bile, Cmax is reached after 6 hours. High concentrations are found in urine; low concentrations - in bile, breast milk, aqueous humor, bronchial secretions, sputum and cerebrospinal fluid. Penetrates well into all tissues of the body, where it accumulates intracellularly; high concentrations are observed in organs with good blood supply: lungs, liver, myocardium, spleen, and especially in the kidneys, where they accumulate in the cortex; lower concentrations are found in muscles, adipose tissue and bones. Normally, kanamycin does not pass through the BBB, however, with inflammation of the meninges, the concentration of the drug in the cerebrospinal fluid reaches 30-60% of that in. In newborns, higher concentrations are created in the cerebrospinal fluid than in adults. Penetrates the placental barrier and is found in fetal blood and amniotic fluid. V d in adults - 0.26 l/kg, in children - 0.2-0.4 l/kg, in newborns under 1 week of age and weighing less than 1.5 kg - up to 0.68 l/kg, under 1 week of age and weighing more than 1.5 kg - up to 0.58 l/kg, in patients with cystic fibrosis - 0.3-0.39 l/kg. Not metabolized.

T1/2 in adults - 2-4 hours, in newborns - 5-8 hours, in older children - 2.5-4 hours. Final T1/2 - more than 100 hours (release from intracellular depots). After parenteral administration, it is excreted by the kidneys by glomerular filtration, mainly unchanged (70-95% is found in urine after 24 hours), when taken orally - with feces. T1/2 in adults with impaired renal function varies depending on the degree of dysfunction up to 100 hours, in patients with cystic fibrosis - 1-2 hours, in patients with burns and hyperthermia T1/2 may be shorter compared to the average due to increased clearance. It is eliminated by hemodialysis (50% in 4-6 hours), peritoneal dialysis is less effective (25% in 48-72 hours).

Indications

For parenteral use: infectious and inflammatory diseases caused by microorganisms sensitive to kanamycin; tuberculosis (in case of mycobacteria resistance to and ftivazide).

For oral administration: intestinal infections caused by sensitive microflora (including dysentery, dysentery bacteria carriage, bacterial colitis, enterocolitis); preparation for operations on the gastrointestinal tract.

For topical use in ophthalmology: conjunctivitis, blepharitis, keratitis, corneal ulcers.

Contraindications

Impaired liver function, hearing loss (including as a result of damage to the auditory nerve), gastrointestinal obstruction, history of hypersensitivity to kanamycin and other aminoglycosides.

For parenteral administration: severe chronic renal failure with azotemia and uremia, neuritis of the VIII pair of cranial nerves, pregnancy.

Dosage

For infections of non-tuberculosis etiology, adults are administered intramuscularly or intravenously (drip) 500 mg every 8-12 hours, the daily dose is 1-1.5 g; the maximum single dose is 1 g with an interval between administrations of 12 hours, the maximum daily dose is 2 g. Duration of treatment is 5-7 days. Children are administered only intramuscularly, the maximum daily dose is 15 mg/kg, the frequency of administration is 2-3 times a day.

For tuberculosis, adults - 1 g 1 time / day, children - 15 mg/kg. Administered daily for 6 days, with a break on the 7th day. The number of courses and total duration of treatment are determined individually.

Kanamycin is administered into cavities (pleural, joint cavity) in the form of an aqueous solution, used in the form of an aerosol and heat-moist inhalation.

When performing peritoneal dialysis, 1-2 g are dissolved in 500 ml of dialysate fluid.

In case of renal failure, the dose should be reduced or the intervals between doses increased.

When taken orally, a single dose for adults is 0.5-1 g. For children, the dose is 50 mg/kg/day. The frequency of use depends on the indications.

Side effects

From the digestive system: nausea, vomiting, diarrhea, liver dysfunction (increased activity of liver transaminases, hyperbilirubinemia); with prolonged oral administration – malabsorption syndrome (diarrhea, flatulence, light, foamy, oily stools).

From the hematopoietic system: anemia, leukopenia, granulocytopenia, thrombocytopenia.

From the central nervous system and peripheral nervous system: headache, drowsiness, weakness, neurotoxic effects (muscle twitching, numbness, tingling, paresthesia, epileptic seizures); with parenteral administration (mainly intravenous and intracavitary), neuromuscular blockade is possible.

From the senses: ototoxicity (ringing or fullness in the ears, hearing loss up to irreversible deafness), toxic effects on the vestibular apparatus (discoordination of movements, dizziness, nausea, vomiting), auditory neuritis; when applied topically - a sensation of a foreign body in the eye (within 3-5 minutes), lacrimation, swelling and hyperemia of the eyelids.

From the urinary system: increased or decreased frequency of urination, thirst, impaired renal function (cylindruria, microhematuria, albuminuria).

Allergic reactions: skin rash, itching, skin hyperemia, fever, Quincke's edema.

Drug interactions

When used simultaneously, beta-lactam antibiotics (cephalosporins, penicillins) in patients with severe chronic renal failure reduce the effect of aminoglycosides.

When used simultaneously, nalidixic acid, polymyxin, and vancomycin increase the risk of developing oto- and nephrotoxicity.

With simultaneous use, diuretics (especially furosemide), cephalosporins, penicillins, sulfonamides and NSAIDs, competing for active secretion in the nephron tubules, block the elimination of aminoglycosides, increase their concentration in the blood serum, increasing nephro- and neurotoxicity.

Cyclopropane increases the risk of apnea with intraperitoneal administration of kanamycin.

Parenteral administration of indomethacin increases the risk of developing toxic effects of aminoglycosides (increased T1/2 and decreased clearance).

Kanamycin reduces the effect of antimyasthenic drugs, enhances the muscle relaxant effect of curare-like drugs, general anesthetics and polymyxins.

With the simultaneous use of methoxyflurane, polymyxins for parenteral administration and other drugs that block neuromuscular transmission (halogenated hydrocarbons as drugs for inhalation anesthesia, opioids, transfusion of large amounts of blood with citrate preservatives), increase the risk of nephrotoxicity and respiratory arrest (in as a result of increased neuromuscular blockade).

Kanamycin is pharmaceutically incompatible with streptomycin, monomycin, penicillins, heparin, cephalosporins, capreomycin, amphotericin B, erythromycin, nitrofurantoin, viomycin.

special instructions

Do not use simultaneously or sequentially with other antibiotics that have ototoxic and nephrotoxic properties (including streptomycin, monomycin, gentamicin, florimycin), together with diuretics (including furosemide, mannitol) and muscle relaxants (strengthening and increasing duration of muscle relaxation).

Use with caution and only for health reasons for myasthenia gravis, parkinsonism, botulism (aminoglycosides can cause disruption of neuromuscular transmission, which leads to further weakening of skeletal muscles), renal failure, and in elderly patients.

If symptoms of side effects appear, kanamycin should be discontinued.

When administered intravenously or intrapleurally, if signs of respiratory depression appear, the administration of kanamycin should be stopped and immediately administered an intravenous solution of calcium chloride and a subcutaneous solution of proserine with atropine. If necessary, the patient is transferred to controlled breathing.

Patients with infectious and inflammatory diseases of the urinary tract are recommended to take increased amounts of fluid. In the absence of positive clinical dynamics, one should remember the possibility of the development of resistant microorganisms. In such cases, it is necessary to discontinue treatment and begin appropriate therapy. Due to the possibility of developing neuromuscular blockade, intravenous administration of undiluted kanamycin is not recommended. In case of hepatic coma, it is used for the purpose of long-term inhibition of bacteria in the intestinal flora to reduce ammonia intoxication.

Use with caution and only for health reasons in case of renal failure.

For liver dysfunction

Contraindicated in case of liver dysfunction.

Use in old age

Use with caution and only for health reasons in elderly patients.

Kanamycin is a broad-spectrum antibiotic that targets acid-fast bacteria. Available in the form of tablets and powder for the preparation of solution for injection (Kanamycin monosulfate and Kanamycin sulfate).

Pharmacological action of Kanamycin

In accordance with the instructions for Kanamycin, the active ingredient of the drug is kanamycin.

Kanamycin is an antibiotic belonging to the aminoglycoside group. It has anti-tuberculosis, bactericidal and antibacterial effects on the body.

The active component of the drug penetrates the cell membrane and binds to receptor proteins with a specific effect on the 30S ribosomal subunit. In this case, the process of complex formation between the 30S ribosomal subunit and messenger RNA is disrupted. This leads to the reading of information from RNA and the formation of defective proteins, as well as the disintegration of polyribosomes and loss of their ability to synthesize protein. Kanamycin changes the functions and structure of cytoplasmic membranes, which provokes the death of microbial cells.

The instructions for Kanamycin indicate that the medicine is active against tuberculosis bacteria, as well as strains that are resistant to para-aminosalicylic acid, streptomycin, isoniazid and other anti-tuberculosis substances, with the exception of capreomycin and viomycin. The effect of the drug applies to most gram-negative and gram-positive microorganisms, including those resistant to erythromycin, chloramphenicol, tetracycline, and acid-fast bacteria. The effect of Kanamycin does not apply to yeast fungi, anaerobes, protozoa and viruses.

It has been noted that bacteria very quickly become resistant to the action of Kanamycin. The drug is recommended for tuberculosis when the virus is resistant to other first- and second-line anti-tuberculosis drugs, with the exception of viomycin.

When taken orally, Kanamycin monosulfate is poorly absorbed from the gastrointestinal tract. It is excreted unchanged from the body through the intestines during natural bowel movements.

When used in the form of inhalations, Kanamycin sulfate is poorly absorbed into the blood, creating high concentrations in the upper respiratory tract and lungs.

When administered intramuscularly, Kanamycin sulfate is completely and quickly absorbed and reaches therapeutic concentrations in the blood after 8 hours. With intravenous drip administration, the therapeutic concentration of the drug in the blood is maintained for 12 hours. Penetrates into the contents of caverns, abscess fluid, as well as pleural, pericardial, peritoneal and synovial fluid. The highest concentrations of Kanamycin are observed in the lungs, liver and kidneys. The period of complete elimination of the drug from the body of an adult is 4-8 hours, for a newborn – 10-16 hours, excreted through the kidneys.

The use of Kanamycin is effective for the treatment of cholangiohepatitis, acute prostatitis, necrotizing enterocolitis in newborns and appendiceal abscess.

Indications for use of Kanamycin

In accordance with the instructions, Kanamycin monohydrate is prescribed:

• for oral use for intestinal decontamination in combination with metronidazole and erythromycin before elective colorectal surgery;
• for the treatment of gastrointestinal tract infections caused by microorganisms sensitive to kanamycin: bacterial colitis, dysentery, enterocolitis.

The medication is also used as an auxiliary drug for hepatic encephalopathy and hepatic coma. Kanamycin monohydrate is used in the form of eye films for blepharitis, conjunctivitis, corneal ulcers, and keratitis.

Kanamycin sulfate is prescribed for infectious diseases caused by pathogens sensitive to it. Parenteral administration of the drug is recommended for tuberculosis (in combination with another anti-tuberculosis drug), infections of joints and bones, respiratory organs, biliary tract, urinary tract, skin and soft tissues. The use of the drug is effective for severe purulent-septic diseases and postoperative infections.

Directions for use and dosage

Kanamycin is intended for oral, intravenous, intramuscular, inhalation, and local use.

Kanamycin monosulfate should be taken orally. For intestinal decontamination, 0.5 g is prescribed 4 times a day for 48 hours before surgery. For hepatic encephalopathy (as an adjuvant), 2-3 g of the drug should be taken every 6 hours.

As ophthalmic films, Kanamycin monohydrate should be used 1-2 times a day. Using sterile ophthalmic tweezers, remove the film from the bottle, then, pulling back the lower eyelid with the fingers of your free hand, place the film in the space that has formed between the eyeball and the eyelid. Then for 1 minute you need to keep your eye closed and motionless.

Kanamycin sulfate for tuberculosis is administered intramuscularly to adults at a dose of 1 g 1 time per day, for people with renal failure and in old age - no more than 0.75 g 1 time per day. The maximum daily dose of the drug should not exceed 2 g. For infections of non-tuberculosis origin for adults, a single dose is 0.5 g every 8-12 hours. With intravenous drip administration of Kanamycin, a daily dose is prescribed at the rate of 15 mg per 1 kg of body weight, which is administered over 30 minutes.

The minimum duration of therapy for tuberculosis is 1 month, for non-tuberculosis infections - up to 7 days. For the purpose of washing, 15-50 ml of a 0.25% aqueous solution is injected into the pleural cavity or joint cavity.

Side effects of Kanamycin

When using Kanamycin monosulfate, gastrointestinal disorders may occur, which are accompanied by nausea, vomiting and diarrhea.

When using Kanamycin sulfate, ototoxicity may occur, accompanied by hearing loss (in rare cases, irreversible deafness occurs), nephrotoxicity, which is accompanied by proteinuria, the appearance of leukocytes, erythrocytes and columnar epithelium in the urine. When administered parenterally, neuromuscular blockade may occur.

With an overdose of Kanamycin, increased side effects are observed.

Contraindications for use

Kanamycin is contraindicated in patients with impaired liver function, hearing loss, gastrointestinal obstruction, or hypersensitivity to the components of the drug.

The medicine is not prescribed to people with severe chronic renal failure, with uremia and azotemia, neuritis of the 8th pair of cranial nerves, as well as women during pregnancy and lactation.

Conditions and shelf life

The instructions for Kanamycin indicate that the drug should be stored in a dark place inaccessible to children. Shelf life – 24 months.

Kanamycin is available from pharmacies by prescription.

Manufacturer: Arterium (Arterium) Ukraine

PBX code: J01GB04

Farm group:

Release form: Liquid dosage forms. Injection.

General characteristics. Compound:

Pharmacological properties:

Indications for use:

Important! Get to know the treatment

Directions for use and dosage:

Features of application:

Side effects:

Interaction with other drugs:

Contraindications:

Overdose:

Storage conditions:

Shelf life: 3 years. Store in original packaging at a temperature not exceeding 20 °C. Keep out of the reach of children.

Vacation conditions: