Streptomycin: Difference between revisions
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***Creatinine Clearance <10: give q72-96h | ***Creatinine Clearance <10: give q72-96h | ||
===Active tuberculosis=== | ===Active [[tuberculosis]]=== | ||
*15 mg/kg IM q24h 5-7x/wk | *15 mg/kg IM q24h 5-7x/wk | ||
**Alternative: 25-30 mg/kg IM 2-3x/wk | **Alternative: 25-30 mg/kg IM 2-3x/wk | ||
===Plague=== | ===[[Plague]]=== | ||
*1g IM q12h x10 days | *1g IM q12h x10 days | ||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
===Tularemia=== | ===[[Tularemia]]=== | ||
*1g IM q12h x10 days | *1g IM q12h x10 days | ||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
| Line 37: | Line 37: | ||
***Creatinine Clearance <10: 7.5 mg/kg give q72-96h | ***Creatinine Clearance <10: 7.5 mg/kg give q72-96h | ||
===Active tuberculosis=== | ===Active [[tuberculosis]]=== | ||
* 20-40 mg/kg IM q24h | * 20-40 mg/kg IM q24h | ||
**Alternative: 20-40 mg/kg IM 2x/wk | **Alternative: 20-40 mg/kg IM 2x/wk | ||
**Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk | **Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk | ||
===Plague=== | ===[[Plague]]=== | ||
* 15 mg/kg IM q12h x10 days | * 15 mg/kg IM q12h x10 days | ||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
===Tularemia=== | ===[[Tularemia]]=== | ||
* 15 mg/kg IM q12h x10 days | * 15 mg/kg IM q12h x10 days | ||
**Maximum dose: 2 g/day (adjust dose based on serum levels) | **Maximum dose: 2 g/day (adjust dose based on serum levels) | ||
| Line 63: | Line 63: | ||
*Contraindicated: | *Contraindicated: | ||
**BCG live intravesical | **BCG live intravesical | ||
**Cidofovir | **[[Cidofovir]] | ||
**Streptozocin | **[[Streptozocin]] | ||
*caution if hypersensitivity to sulfites | *caution if hypersensitivity to sulfites | ||
| Line 97: | Line 97: | ||
===Common=== | ===Common=== | ||
*Nausea | *[[Nausea and vomiting]] | ||
*Vertigo | *[[Vertigo]] | ||
*Paresthesia, facial | *Paresthesia, facial | ||
*Rash | *Rash | ||
*Fever | *Fever | ||
*Urticaria | *Urticaria | ||
*Angioedema | *[[Angioedema]] | ||
*Eosinophilia | *Eosinophilia | ||
*Deafness | *Deafness | ||
*Exfoliative dermatitis | *Exfoliative dermatitis | ||
*Anaphylaxis | *[[Anaphylaxis]] | ||
*Azotemia | *Azotemia | ||
*Leukopenia | *Leukopenia | ||
Revision as of 22:05, 17 July 2014
General
- Type: Aminoglycosides
- Dosage Forms:
- IM
Adult Dosing
Infections, Bacterial
- 1-2 g/day IM divided q6-12h
- Max: 2 g/day; Info: adjust dose based on serum levels
- Renal dosing
- Creatinine Clearance 50-80: give q24h
- Creatinine Clearance 10-50: give q24-72h
- Creatinine Clearance <10: give q72-96h
Active tuberculosis
- 15 mg/kg IM q24h 5-7x/wk
- Alternative: 25-30 mg/kg IM 2-3x/wk
Plague
- 1g IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Tularemia
- 1g IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Pediatric Dosing
Infections, Bacterial
- 20-40 mg/kg IM q24h
- Alternative: 20-40 mg/kg IM 2x/wk
- Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk
- Renal dosing
- Creatinine Clearance 50-80: 7.5 mg/kg give q24h
- Creatinine Clearance 10-50: 7.5 mg/kg give q24-72h
- Creatinine Clearance <10: 7.5 mg/kg give q72-96h
Active tuberculosis
- 20-40 mg/kg IM q24h
- Alternative: 20-40 mg/kg IM 2x/wk
- Maximum dose: 1 g/dose if q24h, or 1.5 g/dose if 2x/wk
Plague
- 15 mg/kg IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Tularemia
- 15 mg/kg IM q12h x10 days
- Maximum dose: 2 g/day (adjust dose based on serum levels)
Special Populations
- Pregnancy Rating: D
- Lactation: Probably Safe
- Monitoring parameters:
- BUN/Cr at baseline, then periodically.
- Serum drug levels
- Urinanalysis
- Audiometry for high risk patients
Contraindications / Cautions
- Contraindicated:
- BCG live intravesical
- Cidofovir
- Streptozocin
- caution if hypersensitivity to sulfites
- caution if impaired vestibular function
- caution if impaired auditory function
- caution if concurrent ototoxic agents
- caution if concurrent neurotoxic agents
- caution if neuromuscular disease
- caution if renal impairment
- caution if dehydration
- caution if concurrent nephrotoxic agent use
- caution if electrolyte abnormalities
- caution if prolonged use
- caution in neonates or infants
- caution in elderly patients
Adverse Reactions
Serious
- Ototoxicity, auditory & vestibular
- Neurotoxicity
- Neuromuscular blockade
- Nephrotoxicity
- Anemia, hemolytic
- Pancytopenia
- Thrombocytopenia
- Anaphylaxis
- Angioedema
- Hypersensitivity reaction
- Exfoliative dermatitis
- Superinfection
Common
- Nausea and vomiting
- Vertigo
- Paresthesia, facial
- Rash
- Fever
- Urticaria
- Angioedema
- Eosinophilia
- Deafness
- Exfoliative dermatitis
- Anaphylaxis
- Azotemia
- Leukopenia
- Thrombocytopenia
- Pancytopenia
- Anemia, hemolytic
- muscle weakness
- Amblyopia
- Injection site reaction
Pharmacology
- Half-life: 5 hours
- Metabolism: Unknown; CYP450
- Excretion: Urine
- Mechanism of Action: Bactericidal (binds to 30S ribosomal subunit, inhibiting protein synthesis)
See Also
Source
Epocrates