{"id":1627,"date":"2023-06-25T17:28:42","date_gmt":"2023-06-25T17:28:42","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/amikacin\/"},"modified":"2023-06-25T19:58:53","modified_gmt":"2023-06-25T19:58:53","slug":"amikacin","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/amikacin\/","title":{"rendered":"Amikacin"},"content":{"rendered":"

<\/p>\n

Amikacin<\/h1>\n

CLINICAL USE<\/h3>\n

Antibacterial agent<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

15 mg\/kg\/day in 2 divided doses (maximum
\ndose: 1.5 g\/day; maximum cumulative dose:
\n15 g)<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           :
    \n585.6<\/li>\n
  • %Protein binding                           :
    \n<20<\/li>\n
  • %Excreted unchanged in urine     :
    \n94\u201398<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n0.22\u20130.29<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n2\u20133\/17\u2013150<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : 5\u20136 mg\/kg every 12 hours<\/li>\n
  • 10 to 20     : 3\u20134 mg\/kg every 24 hours<\/li>\n
  • <10           :
    \n2 mg\/kg every 24\u201348 hours<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nDialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/
    \nmin<\/li>\n
  • HD                     :
    \nDialysed. Give 5 mg\/kg after
    \ndialysis.<\/li>\n
  • HDF\/high flux   :
    \nDialysed. Give 5 mg\/kg after
    \ndialysis.<\/li>\n
  • CAV\/VVHD      :
    \nDialysed. 7.5 mg\/kg every
    \n24 hours and monitor levels1<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Botulinum toxin: neuromuscular blockenhanced \u2013 risk of toxicity<\/li>\n
  • Ciclosporin: increased risk ofnephrotoxicity<\/li>\n
  • Cytotoxics: increased risk with platinumcompounds of nephrotoxicity and possibly
    \nof ototoxicity<\/li>\n
  • Diuretics: increased risk of ototoxicitywith loop diuretics<\/li>\n
  • Muscle relaxants: enhanced effects ofnon-depolarising muscle relaxants and
    \nsuxamethonium<\/li>\n
  • Parasympathomimetics: antagonism ofeffect of neostigmine and pyridostigmine<\/li>\n
  • Tacrolimus: increased risk ofnephrotoxicity
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    Route<\/h4>\n

    IM\/IV<\/p>\n

    Rate of Administration<\/h4>\n

    IV bolus \u2013 slow over 2\u20133 minutes<\/p>\n

    Infusion \u2013 at concentration 2.5 mg\/mL<\/p>\n

    over 30 minutes
    \n(Diluents: sodium chloride 0.9%, glucose<\/p>\n

    5% and others)<\/p>\n

    Comments<\/h4>\n<\/li>\n
  • May be used intraperitoneally<\/li>\n
  • Can be given in 50 mL. (UK Critical CareGroup, Minimum Infusion Volumes for
    \nfluid restricted critically ill patients, 3rd
    \nEdition, 2006.)<\/li>\n
  • Do not mix physically with any otherantibacterial agents
    \n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Nephrotoxic and ototoxic; toxicity noworse when hyperbilirubinaemic
    \nSerum levels must be measured for<\/p>\n

    efficacy and toxicity<\/li>\n

  • Peritoneal absorption increases in thepresence of inflammation<\/li>\n
  • Volume of distribution increases withoedema, obesity and ascites<\/li>\n
  • Peak serum concentration should notexceed 30 mg\/L<\/li>\n
  • Trough serum concentration should beless than 5 mg\/L<\/li>\n
  • Amikacin affects auditory function to agreater extent than gentamicin<\/li>\n","protected":false},"excerpt":{"rendered":"

    Amikacin CLINICAL USE Antibacterial agent DOSE IN NORMAL RENAL FUNCTION<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1627","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1627","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1627"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1627\/revisions"}],"predecessor-version":[{"id":2934,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1627\/revisions\/2934"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1627"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1627"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1627"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}