Tobramycin
Tobramycin is an aminoglycoside antibiotic derived from a complex produced by Streptomyces tenebrarius. The aminoglycosides are the compound containing characteristic amino sugars joined to a hexose nucleus in glycoside linkage. Aminoglycosides are polycations and their polarity accounts for their pharmakokinetic peopertie. Tobramycin is effective against a wide range of aerobic gram negative bacilli and some gram positive bacteria. Tobramycin is used in the treatment of septicemia caused by gram -ve organism, respiratory infections, urinary tract infections, CNS infection. Tobramycin is given topically as eye drops to treat Pseudomonas eye infections. Antibiotics require constant drug level in body for therapeutic effect. This is achieved by taking the medication at regular intervel of time throughout the day and night as prescribed. Tobramycin is important to take the drug for the full time period as prescribed. If you discontinue the therapy, it may result in ineffective treatment.
Primary Characteristics
Tobramycin is also known as Tobramycin Sulphate.
It is of Semi Synthetic origin and belongs to Aminoglycosides.
It belongs to Antibacterial (Proetin synthesis inhibitor) pharmacological group on the basis of mechanism of action.
Molecular Weight: 467.5 · pKa: 6.7, 8.3, 9.9 · Solubility in Water: 1 in 1.5 · Solubility in Alcohol: 1 in 2000 · Non-proprietary name: Tobramycin.
Pharmacokinetics
Absorption: Tobramycin has an oral bioavailability is 5.5% (±4.5%).
Distribution: Tobramycin has a volume of distribution is 0.3 l/kg. plasma protein binding is 10%.
Elimination: plasma half-life is 2 - 3 hr, renal excretion is 90%.
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Indications
Tobramycin is primarily indicated in conditions like Bacterial infections, Biliary tract infections, Chronic pulmonary pseudomonas aeruginosa infection in cystic fibrosis patients, Cystic fibrosis, Endocarditis, Eye infections, Gram +ve (some) and gram -ve (many) infections, Heart failure, Iron deficiency anaemia, NSAID-associated ulceration, Oliguria due to renal failure, Pneumonia in hospital patients, Prohylaxis of stress ulceration, Respiratory tract infections, Septicaemia, Supraventricular arrhythmias (particularly atrial fibrillation), Symptoms associated with carcinoid tumours, Trauma, Ulcerative colitis and crohn's disease, Urinary tract infection, UTI.
Contraindications
Tobramycin is contraindicated in conditions like Hypersensitivity.
Dosage
Tobramycin's dosage details are as follows:
| Dose | Single Dose | Frequency | Route | Instructions |
|---|---|---|---|---|
| Adult Dosage | ||||
| 4 mg/ kg | 4 mg/ kg | — | IM,Slow IV | In 3-4 divided doses. |
| 0.3 % w/v | 0.3 % w/v | Every 6h | Ophthalmic, Otic | |
| Paediatric Dosage (20kg) | ||||
| 2.25 mg/kg | 2.25 mg/kg | Every 8h | Intra Muscular | - |
| 2.25 mg/kg | 2.25 mg/kg | Every 8h | Intra Venous | - |
| Neonatal Dosage (3kg) | ||||
| 2.25 mg/kg | 2.25 mg/kg | Every 8h | Intra Muscular | - |
| 2.25 mg/kg | 2.25 mg/kg | Every 8h | Intra Venous | - |
Drug Interactions
Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Side Effects
Tobramycin in overdosage may give rise to further complications which include Neuromuscular blockage , Ototoxicity , Elevation in serum creatinine .
Tobramycin produces potentially life-threatening effects which include Nephrotoxicity, Dehydration , Proteinuria, Oliguria, Hyperuricemia. Careful monitoring is needed with proper medical management.
Tobramycin is known to cause more or less tolerable side effects which are usually transient. These include Local pain, Maculopapular rash, Phlebitis , Skin reactions, Urticaria.
Warnings / Precautions
Available Brands
Storage Conditions
Drug Classification
- 1.6.2.2.5 — Aminoglycosides
- 2.21.1.1 — Antibacterials
- 3.28 — Otic drugs
Manufacturers
Manufacturers of Tobramycin in Pakistan: