Trepmycin injection powder 1g pharbaco treatment of tuberculosis, leprosy, plague (50 vials)

Dosage form Box of 50 vials
Specifications Streptomycin

Ingredient

Composition informationContent
Streptomycin1g

Uses

Indications

Trepmycin drugs are indicated in the following cases:

  • Combined with other anti -tuberculosis drugs in tuberculosis treatment.
  • Combined with other antibacterial drugs in the treatment of other Mycobacteria diseases, including leprosy.
  • Treatment of tularemia and plague.
  • in combination with tetracyclin or Doxycyclin in the treatment of Brucella disease and combined with tetracycline or sulfonamid to treat horse runny nose (Mallymyces Mallei infection).

    • Use alone or in combination with other anti -bacterial drugs to treat inguinal lymphoma and lower oranges (granuloma inguinale and chancroid).

  • Combined with penicillin or ampicillin is often effective in treating pericarditis in enterococcus and streptococcus.

    • Used alone or in combination with other anti -bacterial drugs in the treatment of tuberculosis, however, Streptomycin is only used in gonorrhea infections due to streptomycin sensitive strains and when other aminosides or other inefficient or contraindications are contraindicated.

    Pharmacy

    Streptomycin is an aminoglycoside antibiotic that has bactericidal effects, by preventing normal bacterial protein synthesis.

    The antibacterial spectrum of Streptomycin includes aerobic gram -negative bacteria and some gram -positive bacteria, Streptomycin does not work with anaerobic bacteria. Streptomycin has a special anti -M. Berculosis and M. Bovis. Streptomycin also has anti -anti -aerobic and anaerobic bacteria such as: Brucella, Francisella Tularensis, Yersinia Pestis, Calymatobacterium Granulomatis, Escherichia Coli, Proteus spp Streptococcus Viridans, Haemophilus Ducreyi, Haemophilus Influenzae.

    Gram -negative bacilli strains and streptomycin Gram -positive bacteria have appeared, limiting the application of streptomycin treatment. Many strains are often sensitive to streptomycin but after a few days or weeks of treatment has become resistant. Most pseudomonas aeruginosa strains are resistant to streptomycin. Currently, Streptomycin is used in combination with other anti -tuberculosis drugs to treat tuberculosis.

    pharmacokinetics

    An hour after the injection of 1g streptomycin, plasma peak concentration reaches about 25 - 59mcg/ml and decreases about 50% after 5 - 6 hours.

    Streptomycin is distributed into most tissues and body fluids. Significant concentration in pleural fluid and tuberculosis caves. Streptomycin penetrates the placenta, the concentration of the umbilical cord is equivalent to the mother's blood. A small amount of streptomycin excreted into milk, saliva and sweat.

    About 20 - 30% Streptomycin binds to plasma proteins. Streptomycin excreted through glomerular filtration, in patients with normal renal function when taking the dose of 600mg of streptomycin, there are about 29 - 89% excreted in the form of urine for 24 hours. Any decrease in glomerular filtration function leads to reducing drug elimination and increasing drug concentration in plasma and in organizations. About 1% of molasses excreted.

    Before taking Trepmycin injection powder 1g pharbaco treatment of tuberculosis, leprosy, plague (50 vials)

    How to use

    Streptomycin sulfate is only used to intramuscularly into a large muscle area. In adults, the most appropriate injection site is the upper - outer buttock or middle - the thigh muscle or Delta muscles. Inject only to Delta muscles for adults or older children and must be cautious when injected to avoid damage to the spinning nerve. Do not intramuscularly in the lower and 1/3 of the arm. When intramuscularly, it must be smoked to avoid injecting into a blood vessel.

    Dosage

    Treatment of tuberculosis and other Mycobacteria diseases

    Do not use alone Streptomycin. When used daily in a tuberculosis treatment regimen, only injecting Streptomycin in the first few months, and other drugs must continue to give the course.

    Common dose:

    Adults

    Use 1g/day or 15mg/kg body weight/day.

    Children

    Use 10mg/kg body weight/day.

    Elderly

    Lower doses depending on age, kidney function and nerve function No. 8.

    The dose is limited to 10mg/kg body weight/day, maximum of 750mg/day.

    When using the exclusive, the dose is commonly used in adults and children is 12 - 18mg/kg body weight (maximum 1.5g) 2-3 times/week.

    Streptomycin is often intramved once a day.

    Tularemia disease

    Common dose:

    Adults

    Use 1 - 2 g/day, divide 2 times, inject for 7-14 days or until the patient is over fever for 5-7 days.

    Plague

    Common dose:

    Adults

    Use 2g/day (30mg/kg body weight), divide 2 times, minimum injection in 10 days.

    Children

    Use 30mg/kg body weight/day, divide 2-3 times, for 10 days.

    Brucella disease

    Coordinate with tetracycline or Doxycyclin.

    Common dose:

    Adults

    Use 1g/time, 1 or 2 times a day for the first week and 1 time/day for at least 1 week next.

    Children over 8 years old

    Use 20mg/kg body weight/day (maximum 1g/day), for 2 weeks. If used in a coordination of streptomycin with cotrimoxazol, at least to inject Streptomycin in the first 2 weeks of treatment.

    Streptococcus pericarditis is sensitive to penicillin (Viridans)

    Coordinate with penicillin.

    Common dose:

    Adults

    Use 1g/time, twice a day for a week, then 500mg, 2 times a day for the next week.

    Patients over 60 years old

    Use 500mg/time, twice a day, for 2 weeks.

    Introphy -caused infections due to Enterococcus

    Coordinate with penicillin

    Common dose:

    Adults

    Use 1g/time, twice a day, for 2 weeks, then use a dose of 500mg, twice a day for 4 weeks.

    If the ear poisoning is poisoned, streptomycin may be stopped before the 6 -week course.

    Moderate and severe infections due to sensitive bacteria

    Common dose

    Adults

    Use 1 - 2g/day, divided into 2-4 times, the total dose does not exceed 2g/day.

    Children

    Can use 20 - 40mg/kg body weight/day, divided into 2-4 times.

    When it is possible to regularly monitor the peak and bottom concentration of the streptomycin in the serum and adjust the dose to maintain the desired concentration in the serum. The peak and bottom serum concentration must not exceed 40 - 50mcg/ml and 5mcg/ml.

    with kidney failure

    Peak concentration in serum must not exceed 20 - 25mcg/ml. If the drug concentration is not determined, the dose can be adjusted based on creatinine clearance coefficient. The initial loading dose is recommended as 1 g, the following dose is suggested as follows:

    Creatinin clearance coefficient (ml/minute)
    Dosage Now

    7.5mg/kg for 72 - 96 hours Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

    What to do when overdose?

    Overdose increases toxicity with hearing. Because there is no specific antidote, the overdose and toxic reactions of Streptomycin should be treated as symptomatic and supportive treatment. Measures include: artificial kidney separation or abdominal separation so that streptomycin type in kidney failure. Use antacistase drugs, calcium salts or use respiratory support therapy, treatment for neurotransmitters, causing respiratory muscle weakness and inhibiting or respiratory paralysis (apnea).

    What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

    Side Effects

    When using Trepmycin, you may experience unwanted effects (ADR).

    As well as other aminoglycosides, the most important side effect is toxic to the ear, due to the damage to the snail nerves and the vestibular wire damage causes dizziness, nerve -muscle blockage, hypersensitivity reactions and rarely toxicity to the kidneys.

    Common, ADR> 1/100

  • Tai: Poisoning for vestibular in children is higher than adults. In patients with normal kidney function, the main factor related to toxicity is daily dose and total treatment dose for a certain period of time. About 30% of the vestibular complications occur when taking a dose of 1g/day for 4 months, 5-15% of cases of hearing loss. Do not use streptomycin more than 60g, 60 doses in 2 months of treatment.
  • Neuromotental ventilation: Visuality disorders (in 50% of cases), paresthesia (often occurring around the mouth and also in other areas on the face and hands), peripheral neuritis.

    • Allergic reactions: Skin rash (occurring in 5% of patients 7 - 9 days after the first injection), Red rash, fever, urticaria, Quincke edema, eosinophilia preferred EOSIN.

    Uncommon, 1/1000

  • Neurological and sensory: Smell or all partial (after a long time of treatment), nerve root inflammation, marrow inflammation and other neurological complications.
  • Neurotransmitter - Mechanical: Respiratory inhibitors.

    • Rare, ADR

  • Neurological and senses: Mental mental distraction.
    • allergies: Stevens - Johnson syndrome, hemolytic anemia, kidney failure, leukopenia, thrombocytopenia, hypoglycemia.

    Instructions on how to handle ADR

    Notify the doctor the unwanted effects encountered when using the drug

    Warnings

    Before using the drug you need to read the instructions carefully and refer to the information below.

    Contraindicated

    Trepmycin drugs contraindicated in the following cases:

  • Hypersensitivity to streptomycin or other aminoglycosides (cross -sensitive).

    • Myasthenia gravis.

    Precautions when using

  • Initial and periodic tests stimulate hot and cold in the ears and hearing tests when treated with streptomycin for a long time. When there is a tinnitus manifestation, an ear drum or a feeling of deafness in the ear, it is necessary to check the hearing or end the treatment or both.

    • Be careful with the user of Streptomycin to avoid sensitivity in the skin usually appears in the 2nd and 3rd week. Like all intramuscular preparations, only streptomycin injections into large muscles and be careful to minimize the possibility of peripheral damage.

  • is very careful to choose the appropriate dose for people with kidney failure. For people with severe hyperuremia, a single dose can create high levels of drugs in the blood for a few days and can accumulate toxic to the ear.
  • When long -term treatment with streptomycin, urine inspection can be minimized or prevented with kidney irritation.
  • Children must not use Streptomycin exceeded the recommended dose, because they have encountered central nervous inhibition syndrome in children overdose.
  • In the treatment of willow disease such as inguinal lymph node tumors or oranges, if suspected to be accompanied by syphilis, some appropriate tests must be performed such as testing test on black background microscopy before starting treatment and conducting monthly serum test for at least 4 months.
  • As well as other antibiotics, using this drug can cause development of non -sensitive microorganisms, including mushrooms. If there is superinfection, appropriate therapy must be performed.

    • The ability to drive and operate machinery

    The drug can cause side effects such as dizziness, vision disorders, mental distraction ... so it is necessary to notify patients when using the drug.

    Pregnancy

    Streptomycin causes fetal damage in pregnancy, because Streptomycin through the placenta is very fast, during the fetal circulation and amniotic fluid, the concentration of the drug in these tissues is usually less than 50% less in the mother serum. In some cases, the toxicity on the ear toxicity of the streptomycin in children because the mother has treated tuberculosis with streptomycin, the newborn is deaf with the negative eyelid screw. In addition to damage to nerve No. 8, there are no other birth defects caused by the use of Streptomycin. Using Streptomycin in the first 3 months of pregnancy can cause deafness in children.

    Breastfeeding period

    Streptomycin pregnancy through breast milk in small amounts. However, the streptomycin is poorly collected by the gastrointestinal tract, so the notice is not found in the breastfeeding.

    Drug interaction

    toxicity with hearing increases if using streptomycin along with ethacrynic acid, furosemid, manitol and can other diuretics.

    Storage

    Store at temperatures below 30 ° C.

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