Tobramycin: Difference between revisions

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{{drugbox
{{Details0|Tobramycin (inhalation)}}
| IUPAC_name = 4-amino-2-[4,6-diamino-3- [3-amino-6-(aminomethyl) -5-hydroxy-tetrahydropyran-2-yl]oxy- 2-hydroxy-cyclohexoxy]-6-(hydroxymethyl) tetrahydropyran-3,5-diol
{{Details0|Tobramycin (Injection)}}
| image = Tobramycin_vector.svg
{{Details0|Tobramycin (opthalmic)}}
| CAS_number = 32986-56-4
| ATC_prefix = J01
| ATC_suffix = GB01
| ATC_supplemental = {{ATC|S01|AA12}}
| PubChem = 5496
| DrugBank = APRD00582
| C=18 | H=37 | N=5 | O=9
| molecular_weight = 467.515 g/mol
| bioavailability =
| protein_bound = < 30%
| metabolism =
| elimination_half-life =
Neonates < 1200 g: 11 hrs; > 1200 g 2-9 hrs
Adults: 2-3 hours; longer with impaired renal function
| pregnancy_category = D (Injection, Inhalation); B (Ophthalmic) <small>([[US]])</small>
| legal_status =
| routes_of_administration = IV, IM, inhalation, ophthalmic
}}
{{SI}}
{{EH}}
 
'''Tobramycin sulfate''' is an [[aminoglycoside]] [[antibiotic]] used to treat various types of [[bacterium|bacteria]]l infections, particularly [[Gram-negative]] infections.
 
==Mechanism of action==
Tobramycin works by binding to a site on the bacterial [[30S]] and [[50S]] [[ribosome]], preventing formation of the 70S complex.  As a result, [[mRNA]] cannot be [[Translation (biology)|translated]] into protein and cell death ensues.
 
==Administration==
Like all aminoglycosides, tobramycin does not pass the [[gastro-intestinal tract]], so for [[systemic]] use it can only be given [[Intravenous therapy|intravenously]] or [[Intramuscular injection|intramuscularly]]. This formulation for injection is branded Nebcin®. Patients with [[cystic fibrosis]] will often take an [[inhaler|inhalational]] form (Tobi®) for suppression of ''[[Pseudomonas aeruginosa]]'' infections. Tobramycin is also combined with [[dexamethasone]] as an [[TobraDex|ophthalmic solution]] (TobraDex®).
 
Bausch & Lomb Pharmaceuticals, Inc. makes a sterile Tobramycin [[Ophthalmology|Ophthalmic]] Solution (eye-drops) with a tobramycin concentration of 0.3%, which is available by prescription only in the United States and Canada. (In some countries, such as Italy, it is available over the counter.)  It is mixed with 0.01% [[benzalkonium chloride]] as a preservative.  These concentrations result in 3 mg per ml and 0.1 mg per ml, respectively.
 
==Side effects==
Like other aminoglycosides, tobramycin can cause [[deafness]] or a loss of [[equilibrioception]] (vertigo) in genetically susceptible individuals. These individuals have a normally harmless mutation in their DNA, that allows the tobramycin to affect their cells. The cells of the [[ear]] are particularly sensitive to this.
 
Tobramycin can also be highly [[nephrotoxic|toxic]] to the [[kidney]]s, particularly if multiple doses accumulate over a course of treatment.
 
For these reasons, when tobramycin is given [[parenteral]]ly, it is usually dosed by [[body weight]]. Various formulae exist for calculating tobramycin dosage. Also serum levels of tobramycin are monitored during treatment.
 
{{AminoglycosideAntiBiotics}}
 
[[Category:Aminoglycoside antibiotics]]
 
{{SIB}}
[[fr:Tobramycine]]
[[pl:Tobramycyna]]
[[th:โทบรามัยซิน]]
[[tr:Tobramisin]]
 
{{WH}}
{{WikiDoc Sources}}

Latest revision as of 19:19, 6 May 2015