Amikacin + Cefepime Pharmacology

Amikacin + Cefepime

About Amikacin + Cefepime
N/A
Mechanism of Action of Amikacin + Cefepime
N/A
Pharmacokinets of Amikacin + Cefepime
N/A
Onset of Action for Amikacin + Cefepime
N/A
Duration of Action for Amikacin + Cefepime
N/A
Half Life of Amikacin + Cefepime
N/A
Side Effects of Amikacin + Cefepime
N/A
Contra-indications of Amikacin + Cefepime
Cefepime and Amikacin is contraindicated in patients who have shown immediate hypersensitivity reactions to Cefepime or the cephalosporin class of antibiotics, penicillins or other betalactam antibiotics.
Special Precautions while taking Amikacin + Cefepime
N/A
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution,dose reduction may be needed
Breast Feeding Related Information
Use with caution
Children Related Information
N/A
Indications for Amikacin + Cefepime
1.Nosocomial infections
2.Febrile neutropenia
3.Serious respiratory infections
4.Burns
5.Post-operative infections
6.Serious & complicated urinary tract infections
7.Uncomplicated skin infections
8.Complicated intra abdominal infections
Interactions for Amikacin + Cefepime
1.Renal function should be monitored carefully with Cefepime and Amikacin because of the
increased potential of nephrotoxicity and ototoxicity of aminoglycoside antibiotics.
2.The concurrent use of Amikacin with potent diuretics (ethacrynic acid, or furosemide) should be
avoided since diuretics by themselves may cause ototoxicity.
3.Nephrotoxicity has been reported following concomitant administration of other cephalosporins with potent diuretics such as furosemide.
Typical Dosage for Amikacin + Cefepime
The usual adult daily dose is 1.25-2.5 grams given twice a day in equally divided doses depending on the type and severity of infection.

The patient?s pretreatment body weight should be obtained for calculation of correct dosage.
It is given intravenously. The usual duration of treatment is 7 to 10 days.

Cefepime and Amikacin should be administered intravenously for approximately 30-60 minutes.
The status of renal function should be estimated by measurement of the serum creatinine concentration or calculation of the endogenous creatinine clearance rate.

The blood urea nitrogen (BUN) is much less reliable for this purpose. Reassessment of renal function should be made periodically during therapy.
Schedule of Amikacin + Cefepime
N/A
Storage Requirements for Amikacin + Cefepime
N/A
Effects of Missed Dosage of Amikacin + Cefepime
N/A
Effects of Overdose of Amikacin + Cefepime
Patients who receive an overdose should be carefully observed and given supportive treatment. In the presence of renal insufficiency, hemodialysis, not peritoneal dialysis, is recommended to aid in the removal of drugs from the body.

Amikacin

About Amikacin
Aminoglycoside Antibiotic.
Mechanism of Action of Amikacin
Amikacin exerts its bactericidal action against gram- negative organisms & some of gram positive organisms by inhibiting bacterial protein synthesis. The process involves 1. Penetration of bacterial cell membrane & binding directly to the bacterial ribosome, 2. Misleading of m-RNA codon by bacterial ribosome, 3. Formation of peptide chains with wrong amino acid sequence which gets incorporated into bacterial cell membrane and alters it`s permeability, 4. Bacterial cell lysis. It has broadest spectrum of activity among amino glycosides.
Pharmacokinets of Amikacin
Absorption: Poorly absorbed orally, Distribution: Distributed extracellularly. CSF penetration & intraocular penetration poor. Metabolism:
Not metabolized, Excretion: Excreted mainly through urine.
Onset of Action for Amikacin
Within mins.
Duration of Action for Amikacin
8 to 12 hours
Half Life of Amikacin
2 to 3 hours
Side Effects of Amikacin
1.Cochlear damage & hearing loss(ototoxicity)
2.Nephrotoxicity
3.Neuro muscular disorders
Contra-indications of Amikacin
1.Hypersensitivity to the drug or other amino glycosides
2.Never use along with other nephrotoxic drugs
Special Precautions while taking Amikacin
1.Renal impairment
2.Neuromuscular disorders
3. Auditory disorders
Pregnancy Related Information
Contraindicated.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Contraindicated.
Children Related Information
Use with caution.
Indications for Amikacin
1.Infections caused by sensitive organisms like pseudomonas aeruginosa klebsiella, proteous etc.
2.Multi Drug Resistant Tuberculosis
3.Urinary Tract Infections
Interactions for Amikacin
Amphotericin B, Cisplatin, Cephalosporin, Vancomycin, Methoxyflurane, Frusemide, Bumetanide: Increased nephrotoxicity.
Anaesthetics, Neuromuscular blocking agents (Tubocurarine): Risk of neuromuscular blockade and respiratory paralysis.
Penicillin, Cephalosporins, Carbenicillin, Ticarcillin: Exert antibiotic synergism, especially useful in Pseudomonas infections.
Loop diuretics: Concurrent use of these agents may increase the risk of respiratory paralysis and renal dysfunction.
Lab Tests: Aminoglycoside serum levels: Guard against in-vitro inactivation of aminoglycosides by b-lactum antibiotics in patients on combination therapy.
Typical Dosage for Amikacin
Adults & Children: 15mg/kg/day in 1 to 3 doses; given intravenously or Intramuscularly
Adults: 4 to 20 mg intrathecally as single dose.
Tuberculosis: 15mg/kg/day 5 times weekly
Urinary Tract Infections: 7.5 mg/kg/day
Neonates: 10mg/kg intramuscularly or intravenously followed by 7.5 mg/kg twice Daily.

Schedule of Amikacin
H
Storage Requirements for Amikacin
Store in a cool dry place and protect from light. Keep out of reach of children.
Effects of Missed Dosage of Amikacin
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Amikacin
An overdose results in Ototoxicity, nephrotoxicity, neuromuscular disorders & hypersensitivity manifestations. Treatment includes removal of drug by dialysis, &drug treatment with neostigmine, Ca, & Prednisolone.

Cefepime

About Cefepime
Fourth Generation cephalosporin antibiotic.
Mechanism of Action of Cefepime
Cefepime is a 3rd generation cephalosporin which exerts its bactericidal action by inhibiting bacterial cell wall synthesis. Cefepime inhibits transpeptidase & thus prevents cross linking of bacterial cell wall. Transpeptidase & associated proteins constitute various types of specific binding proteins which have affinity for cephalosporins like Cefipime
Pharmacokinets of Cefepime
Well absorbed after Parenteral administration, Distribution: widely distributed, Metabolism: It is metabolized inside the body Excretion: Excreted mainly through urine
Onset of Action for Cefepime
30 minutes
Duration of Action for Cefepime
N/A
Half Life of Cefepime
N/A
Side Effects of Cefepime
1.Pain after I.M. injection & thrombophlebitis after I.V. injection.
2 Rashes
3.Vaginitis
4.Pruritus
5.Candiasis
6.Nephrotoxicity
7.Pseudo membranous colitis
8.Nausea
9.Vomiting
10.Elevated liver enzymes
11.Headache
12.Dizziness
13.Hypotention
14.Vertigo
Contra-indications of Cefepime
1.Hypersensitivity to cephalosporins or Penicillins
2.Along with other nephrotoxic drugs
Special Precautions while taking Cefepime
1.Renal impairment
2.Pseudo membranous colitis
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Use with caution.
Children Related Information
Contraindicated
Neonates: contraindicated
Indications for Cefepime
1.Pneumonia
2.Resistant hospital acquired infections
3.Septicemia,
4.Empiric therapy in febrile neutropenic patients
5.Urinary tract infections
6.Pyelonephritis
7.Tonsillitis, Pharyngitis etc.
8.Skin & soft tissue infections
Interactions for Cefepime
N/A
Typical Dosage for Cefepime
Adults: 1 to 2 gm I.V. twice daily or thrice daily
Urinary tract infections:500mg to 1gm I.V. or I.M. twice daily for 10 days. In severe cases dose may be increased up to 2gm twice daily for 10 days
Infections in neutropenic patients:6gm/day in 3 divided doses; for 1week
Pneumonia:1 to 2 gm twice daily for 10 days
Intra abdominal infections:2gm twice daily for 10 days
Schedule of Cefepime
H
Storage Requirements for Cefepime
Store in a temperature range of 2 degree to 25 degree C and protect from light.
Effects of Missed Dosage of Cefepime
Take the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose.
Effects of Overdose of Cefepime
Symptoms of over dosage include neuromuscular disorders and may precipitate seizures. Treatment includes removal of drug from the body by hemodialysis & supportive measures

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