নির্দেশনা
Colistimethate is indicated for the treatment of acute or chronic infections caused by sensitive strains of certain gram-negative bacilli. It is particularly indicated in the infection caused by sensitive strains of Pseudomonas aeruginosa. Colistimethate is not indicated for infections due to Proteus ... Read more Colistimethate is indicated for the treatment of acute or chronic infections caused by sensitive strains of certain gram-negative bacilli. It is particularly indicated in the infection caused by sensitive strains of Pseudomonas aeruginosa. Colistimethate is not indicated for infections due to Proteus or Neisseria. Colistimethate is very effective in the treatment of infections due to the following gram-negative organisms: Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa.
উপাদান
ফার্মাকোলজি
Colistimethate is a surface active agent which penetrates into and disrupts the bacterial cell membrane. Colistimethate is polycationic and has both hydrophobic and lipophilic moieties. It interacts with the bacterial cytoplasmic membrane, changing its permeability. This effect is bactericidal. There is also evidence that polymyxins enter the cell and precipitate cytoplasmic components, primarily ribosomes.
মাত্রা ও সেবনবিধি
Maintenance dose : 9 MIU/day in 2-3 divided doses. In patients who are critically ill, a loading dose of 9 MIU should be administered. Renal impairment patients : Dose adjustments in renal impairment patients are necessary. Dose reductions are recommended for patients with creatinine clearance < 50 ml/min. Twice daily dosing is recommended. Creatinine clearance <50-30 ml/min: daily dose 5.5-7.5 MIU Creatinine clearance <30-10 ml/min: daily dose 4.5-5.5 MIU Creatinine clearance <10 ml/min: daily dose 3.5 MIU Haemodialysis (HD) patients: No-HD days: 2.25 MIU/day (2.2-2.3 MIU/day). HD days: 3 MIU/day (Should be given after the HD session) Twice daily dosing is recommended. Pediatric population : The dose should be based on lean body weight. Children ≤40 kg: 75,000-150,000 IU/kg/day divided into 3 doses. Children >40 kg: >150,000 IU/kg/day has been reported in children with cystic fibrosis. Hepatic impairment patients : There are no data in patients with hepatic impairment. Caution is advised when administering colistimethate sodium in these patients.
প্রতিনির্দেশনা
The use of Colistimethate Sodium Parenteral is contraindicated for patients with a history of sensitivity to the drug or any of its components.
পার্শ্ব প্রতিক্রিয়া
The following adverse reactions have been reported: gastrointestinal upset, tingling of extremities and tongue, slurred speech, dizziness, vertigo and paresthesia, generalized itching, urticaria and rash, fever, increased blood urea nitrogen (BUN), elevated creatinine and decreased creatinine clearance, respiratory distress and apnea, nephrotoxicity and decreased urine output.
গর্ভাবস্থায় ও স্তন্যদানকালে
There are no adequate and well-controlled studies about the use of Colistimethate in pregnant women. Since colistimethate is transferred across the placental barrier in humans, it should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Colistimethate is excreted in human breast milk. Therefore, caution should be exercised when administered to nursing women.
সতর্কতা
Colistimethate should be used with caution in patient with impaired renal function. When actual renal impairment is present, Colistimethate may be used, but the greatest caution should be exercised and the dosage should be reduced in proportion to the extent of the impairment. Colistimethate should be used with caution in neonates, infants and children.
থেরাপিউটিক ক্লাস
Other antibacterial preparation
সংরক্ষণ
Before reconstitution: Store below 30°C. After reconstitution: Store at 2°C to 8°C (Do not freeze) and use within 24 hours.