토브라마이신

용도

• General susceptible infections
• Susceptible UTI
• Sepsis
• Soft tissue, systemic infections
• Persistent bacteremia
• Gram-negative infections
• Susceptible infections
• Susceptible infections
• Susceptible infections
• Susceptible infections (Llamas)
• Susceptible infections
• General susceptible infections
• Susceptible UTI
• Sepsis

투여 방법

가능한 부작용

• Nephrotoxicity (acute tubular necrosis)
• Ototoxicity (vestibular and auditory damage, potentially irreversible)
• Neuromuscular blockade
• Facial edema
• Pain or inflammation at the injection site
• Peripheral neuropathy
• Hypersensitivity reactions
• Rarely: GI signs, hematologic, and hepatic effects
• Ototoxicity (vestibular and auditory damage)
• Neuromuscular blockade (rare)

주의사항 및 금기

• Known hypersensitivity to aminoglycosides
• Rabbits and hares (causes fatal disruption of GI flora)
• Pre-existing severe renal disease (unless benefits outweigh risks)
• Dehydration
• Corneal ulceration (specifically for ophthalmic preparations)
• **Extreme Caution Required:** * **Renal Impairment:** Use with extreme caution in patients with preexisting renal disease. Dosage intervals must be extended, and therapeutic drug monitoring is highly recommended. * **Risk Factors:** Neonatal and geriatric patients, fever, sepsis, and dehydration significantly increase the risk of toxicity. * **Working Dogs:** Use cautiously in working dogs (e.g., seeing-eye, herding, hearing-assistance dogs) due to the risk of irreversible ototoxicity (deafness or vestibular dysfunction). * **Neuromuscular Disorders:** Avoid or use with extreme caution in patients with myasthenia gravis or other neuromuscular disorders due to the drug's neuromuscular blocking activity. * **Feline Sensitivity:** Cats appear to be particularly sensitive to the vestibular toxic effects of aminoglycosides.

약물 상호작용

• Beta-lactam antibiotics (penicillins, cephalosporins): Synergistic antibacterial effects in vivo; however, can cause physical inactivation of aminoglycosides if mixed in the same syringe or IV line, or in vivo in patients with severe renal failure.
• Cephalosporins: Potential for additive nephrotoxicity (historically documented with older generation cephalosporins like cephalothin).
• Loop Diuretics (furosemide, torsemide): Increased risk of nephrotoxicity and ototoxicity.
• Osmotic Diuretics (mannitol): Increased risk of nephrotoxicity and ototoxicity.
• Other Nephrotoxic Drugs (cisplatin, amphotericin B, polymyxin B, vancomycin): Significantly increased risk of acute kidney injury.
• Neuromuscular Blocking Agents & General Anesthetics: Concomitant use can potentiate and prolong neuromuscular blockade, potentially leading to respiratory paralysis.
• Amphotericin B: Increased risk of nephrotoxicity
• Furosemide: Increased risk of ototoxicity and nephrotoxicity
• Heparin: In vitro chemical inactivation if mixed
• Pancuronium: Enhanced non-depolarizing neuromuscular blockade

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