Colistimethate sodium


Thông tin thuốc gốc
Chỉ định và Liều dùng
Inhalation/Respiratory
Pseudomonal lung infections in cystic fibrosis
Adult: 1-2 MIU bid or tid. Max: 6 MIU daily. Dose may be adjusted based on patient’s condition and clinical response.
Child: <2 yr 0.5 to 1 MIU bid. Max: 2 MIU daily; ≥2 yr Same as adult dose.

Parenteral
Severe Gram-negative infections
Adult: ≤60 kg: 50,000 IU/kg daily in 3 divided dose. Max: 75,000 IU/kg daily; >60 kg: 1-2 MIU tid. Max: 6 MIU 24 hrly. Doses are given via IM inj or slow IV inj or infusion.
Child: Same as adult dose.
Renal Impairment
Parenteral:
Dosage reduction needed (according to individual products).
Hướng dẫn pha thuốc
IV: Reconstitute vial containing 1 MIU w/ not more than 10 mL sterile water for inj or NaCl 0.9%. IV infusion: Further dilute reconstituted solution w/ 50 mL NaCl 0.9%. Gently swirl to avoid frothing.
Chống chỉ định
Hypersensitivity to colistimethate or colistin.
Thận trọng
Patient w/ myasthenia gravis, porphyria. Renal impairment. Childn (esp infants <1 yr). Pregnancy and lactation.
Phản ứng phụ
Significant: Bronchospasm and cough (inhalation); nephrotoxicity or neurotoxicity (IM/IV).
Nervous: Confusion or psychosis, transient sensory disturbances (e.g. facial paraesthesia, vertigo), slurred speech, dizziness, vertigo.
CV: Vasomotor instability.
GI: Sore mouth or throat, dysgeusia, GI disturbance.
Resp: Haemoptysis, dysphonia, epistaxis, pharyngolaryngeal pain, apnoea, dyspnoea, cough, wheezing.
Musculoskeletal: Arthralgia.
Ophthalmologic: Visual disturbances.
Otic: Tinnitus.
Dermatologic: Rash, pruritus, urticaria.
Immunologic: Anaphylaxis.
Others: Pain and local irritation, fever.
Potentially Fatal: Antibiotic-associated colitis and pseudomembranous colitis, resp arrest.
IM/Inhalation/Respiratory/IV/Parenteral: C
Thông tin tư vấn bệnh nhân
This drug may cause dizziness, confusion, or visual disturbance, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor serum creatinine, BUN, urine output; signs of neurotoxicity or bronchospasm.
Quá liều
Symptoms: Muscular weakness, apnoea. Resp arrest and acute renal failure may also occur. Management: Supportive treatment, including mannitol diuresis. May be removed by prolonged haemodialysis or peritoneal dialysis.
Tương tác
Additive nephrotoxic/neurotoxic effects w/ aminoglycosides, amphotericin B, bacitracin, capreomycin, cefazedone, methoxyflurane, polymyxin B, vancomycin. May prolong the effect of non-depolarising muscle relaxants (e.g. tubocurarine). May diminish therapeutic effect w/ Na picosulfate.
Tác dụng
Description: Colistimethate Na is an inactive prodrug which is hydrolysed to colistin. Colistin acts as a cationic detergent which penetrates and disrupts the bacterial cytoplasmic membrane, causing leaking of intracellular substances and cell death.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: 2-3 hr (IM).
Distribution: Widely distributed, except in CNS and in synovial, pleural, and pericardial fluids; crosses placenta and enters breast milk. Plasma protein binding: 50%.
Metabolism: Undergoes hydrolysis to the active substance colistin.
Excretion: Mainly via urine, as unchanged drug. Elimination half-life: 2-3 hr.
Đặc tính

Chemical Structure Image
Colistimethate sodium

Source: National Center for Biotechnology Information. PubChem Database. Colistimethate, CID=216258, https://pubchem.ncbi.nlm.nih.gov/compound/Colistimethate (accessed on Jan. 22, 2020)

Bảo quản
Store between 20-25°C. Protect from light. 
Phân loại MIMS
References
Anon. Colistimethate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/06/2017.

Buckingham R (ed). Colistimethate Sodium. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/06/2017.

Colistimethate Sodium Injection (Par Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/06/2017.

Joint Formulary Committee. Colistimethate Sodium. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/06/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Colistimethate Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 06/06/2017.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Colistimethate sodium từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2021 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in