Hypersensitivity (including trenbolone enanthate stack to other aminoglycosides in history.), Neuritis of the auditory nerve, severe chronic renal failure with azotemia and uremia, pregnancy. Precautions – Myasthenia gravis, parkinsonism, botulism (aminoglycosides may cause a violation of neuromuscular transmission that leads to a further weakening of the skeletal muscles), dehydration, renal failure, the neonatal period, premature babies, old age, the period of lactation.
Dosing and dose
/ m in / in (jet for 2 min or infusion), 5 mg / kg every 8 hours or 7.5 mg / kg every 12 hours; bacterial infections of the urinary tract (uncomplicated) – 250 mg every 12 hours; additional dose may be administered after hemodialysis session – 3-5 mg / kg. The maximum dose for adults – 15 mg / kg / day, but not more than 1.5 g / day for 10 days.
The duration of treatment with a / in the introduction – 3-7 days, with the / m – 7-10 days.
Preterm infants initial dose – 10 mg / kg, followed by 7.5 mg / kg every 18-24 hours; Neonatal initial dose – 10 mg / kg followed by 7.5 mg / kg every 12 hours for 7-10 days.
Patients with kidney failure require correction mode.
Patients with burns may require a dose of 5-7.5 mg / kg every 4-6 hours in connection with a shorter T1 / 2 (1-1.5ch) in these patients.
For on / in the same solutions apply as for the / m, after dilution with 200 ml of 5% dextrose or 0.9% NaCl solution. The concentration of amikacin trenbolone enanthate stack in the solution for the on / in the introduction should not exceed 5 mg / ml.
From the digestive system: nausea, vomiting, abnormal liver function (increased activity of “liver” transaminases, hyperbilirubinemia).
From the side of blood: anemia, leukopenia, granulocytopenia, thrombocytopenia.
From the nervous system: headache, drowsiness, neurotoxic effects (muscle twitching, numbness, tingling, seizures), violation of neuromuscular transmission (cessation of breathing).
From the senses: ototoxicity (hearing loss, vestibular and labyrinth disorders, irreversible deafness), toxic effects on the vestibular apparatus (discoordination movements, dizziness, nausea, vomiting).
From the urinary system: renal toxicity – renal dysfunction (oliguria, proteinuria, microscopic hematuria).
Allergic reactions: skin rash, itching, skin redness, fever, angioedema.
Symptoms: The toxic effects trenbolone enanthate stack (hearing loss, ataxia, dizziness, urinary disorders, thirst, loss of appetite, nausea, vomiting, ringing or a sensation of laying in the ears, respiratory failure). Treatment: for the lifting of the blockade of neuromuscular transmission and its consequences – hemodialysis or peritoneal dialysis; anticholinesterase agents, Ca2 + salts, mechanical ventilation, etc., symptomatic and supportive therapy.
Interaction with other drugs
Pharmaceutical incompatible with penicillins, heparin, cephalosporins, capreomycin, amphotericin B, hydrochlorothiazide, erythromycin, nitrofurantoin, vitamin B and C, potassium chloride.
Shows synergies in cooperation with carbenicillin, benzylpenicillin, cephalosporins (in patients with severe chronic renal failure when combined with beta-lactam antibiotics may reduce the effectiveness of aminoglycosides).
Nalidixic acid, polymyxin B, vancomycin cisplatin and increase the risk of nephrotoxicity and dis-.
Diuretics (furosemide, especially), cephalosporins, penicillins, sulfonamides, and nonsteroidal antiinflammatory drugs competing for active secretion into tubules of the nephron, aminoglycosides inhibit elimination, increasing their concentration in the blood serum, increasing nephrotoxicity and neurotoxicity.
It enhances muscle relaxant action curariform drugs.
Parenteral administration capreomycin and others. Drugs that block neuromuscular transmission (halogenated hydrocarbons as preparations for inhalation anesthesia, opioid analgesics), transfusion of large quantities of blood with citrate preservative increase the risk of apnea (especially after intraperitoneal injection of amikacin).
Parenteral administration of indomethacin increases the risk of toxic deystviyy aminoglycosides (increased half-life and reduced clearance).
It reduces the effect of antimiastenicheskih .
Before use, determine the sensitivity of isolated pathogens, using disks containing 30 micrograms amikacin. With a diameter of 17 mm in a free zone and a microorganism growth is considered sensitive, from 15 to 16 mm – moderately sensitive, less than 14 mm – stable.
The concentration of amikacin in the plasma should not exceed 25 mg / ml (therapeutic concentration is 15-25 mg / ml).
In the period of treatment should be at least 1 time per week to monitor kidney function, auditory nerve and vestibular apparatus.
The likelihood of nephrotoxicity was higher in patients with impaired renal function, as well as in high doses or for a long time (in these patients may require daily monitoring of renal function).
When poor audiometric test dose reduce or stop treatment.
In the presence of vital evidence trenbolone enanthate stack can be used in pregnant and lactating women (aminoglycosides penetrate into breast milk in small amounts. However, they are poorly absorbed from the gastrointestinal tract, and associated complications have been recorded in infants).
Patients with infectious and inflammatory diseases of the urinary tract is recommended to take an increased amount of fluid.
In the absence of positive clinical dynamics should be aware of the possibility of development of resistant organisms. In such cases it is necessary to cancel the treatment and initiate appropriate therapy.
Contained in ampoules of sodium bisulfite may cause the development of allergic complications in patients (up to anaphylactic reactions), especially in patients with a history of allergenic.