Amikacin

Amikacin Brand Names- Amikin | Amikin Pediatric | ARIKAYCE

What is Amikacin

Amikacin is an aminoglycoside antibiotic that is active against aerobic gram-negative rods. It also possesses activity against certain Mycobacterium species, but is not active against any anaerobic bacteria.

Amikacin is used as part of combination treatment for gram-negative respiratory tract, abdominal, CNS infections. It is also used as part of second-line therapy for Mycobacterium avium complex (MAC) lung disease.

Amikacin is considered to be a narrow therapeutic index drug, and therefore, serum concentration monitoring is recommended for most regimens.

The major toxicities include nephrotoxicity, ototoxicity, and neurotoxicity. Amikacin liposome inhalation therapy is associated with an increased risk of respiratory adverse reactions that have led to hospitalizations in some cases.

Indications

1. Acinetobacter sp.
2. actinomycotic mycetoma
3. Aeromonas sp.
4. Bacillus anthracis
5. bacteremia
6. bone and joint infections
7. burn wound infection
8. cellulitis
9. Citrobacter freundii
10. Citrobacter sp.
11. community-acquired pneumonia
12. cystic fibrosis
13. endocarditis
14. Enterobacter sp.
15. Escherichia coli
16. febrile neutropenia
17. Haemophilus influenzae (beta-lactamase negative)
18. Haemophilus influenzae (beta-lactamase positive)
19. infectious arthritis
20. intraabdominal infections
21. Klebsiella sp.
22. lower respiratory tract infections
23. meningitis
24. Morganella sp.
25. Mycobacterium avium
26. Mycobacterium avium complex infection
27. Mycobacterium fortuitum
28. Mycobacterium intracellulare
29. Mycobacterium tuberculosis
30. Nocardia sp.
31. nocardiosis
32. nosocomial pneumonia
33. osteomyelitis
34. peritonitis
35. pneumonia
36. Proteus sp.
37. Providencia rettgeri
38. Providencia sp.
39. Providencia stuartii
40. Pseudomonas aeruginosa
41. Pseudomonas sp.
42. pyelonephritis
43. Salmonella sp.
44. sepsis
45. Serratia marcescens
46. Serratia sp.
47. Shigella sp.
48. skin and skin structure infections
49. Staphylococcus sp.
50. tuberculosis infection
51. urinary tract infection (UTI)
52. ventriculitis

Side Effects

1. anaphylactoid reactions
2. anemia
3. anxiety
4. aphonia
5. apnea
6. arthralgia
7. asthenia
8. azotemia
9. back pain
10. bronchospasm
11. candidiasis
12. cough
13. cylindruria
14. diarrhea
15. dizziness
16. dysgeusia
17. dysphonia
18. dyspnea
19. encephalopathy
20. eosinophilia
21. epistaxis
22. fatigue
23. fever
24. headache
25. hearing loss
26. hemoptysis
27. hyposthenuria
28. hypotension
29. infection
30. injection site reaction
31. interstitial lung disease
32. laryngitis
33. maculopapular rash
34. myalgia
35. myasthenia
36. nausea
37. nephrotoxicity
38. neurotoxicity
39. ototoxicity
40. paresthesias
41. peripheral neuropathy
42. pneumonitis
43. pneumothorax
44. proteinuria
45. pseudomembranous colitis
46. pyuria
47. rash
48. renal tubular acidosis (RTA)
49. renal tubular necrosis
50. seizures
51. superinfection
52. tetany
53. throat irritation
54. tinnitus
55. urticaria
56. vertigo
57. vitamin B12 deficiency
58. vitamin B6 deficiency
59. vomiting
60. weakness
61. weight loss
62. wheezing
63. xerostomia

Monitoring Parameters

• audiometry
• serum aminoglycoside concentrations
• serum creatinine/BUN

Contraindications

• acute bronchospasm
• aminoglycoside hypersensitivity
• asthma
• botulism
• breast-feeding
• chronic obstructive pulmonary disease (COPD)
• dehydration
• diarrhea
• electrolyte imbalance
• geriatric
• GI disease
• hearing impairment
• inflammatory bowel disease
• myasthenia gravis
• neonates
• nephrotoxicity
• neuromuscular blockade
• neuromuscular disease
• neurotoxicity
• ototoxicity
• parkinsonism
• pregnancy
• premature neonates
• pseudomembranous colitis
• pulmonary disease
• renal disease
• renal failure
• renal impairment
• respiratory depression
• respiratory insufficiency
• tinnitus
• ulcerative colitis

Interactions

• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Diphenhydramine
• Acyclovir
• Adefovir
• Aldesleukin, IL-2
• Aminosalicylate sodium, Aminosalicylic acid
• Amlodipine; Celecoxib
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Aprotinin
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atracurium
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Bacillus Calmette-Guerin Vaccine, BCG
• Bacitracin
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Beractant
• Bictegravir; Emtricitabine; Tenofovir Alafenamide
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bleomycin
• Botulinum Toxins
• Bumetanide
• Calfactant
• Capreomycin
• Carbetapentane; Chlorpheniramine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carboplatin
• Cefepime
• Cefotaxime
• Cefotetan
• Cefoxitin
• Cefprozil
• Ceftazidime
• Ceftazidime; Avibactam
• Ceftizoxime
• Cefuroxime
• Celecoxib
• Chlorpheniramine
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Choline Salicylate; Magnesium Salicylate
• Cidofovir
• Cisatracurium
• Cisplatin
• Clofarabine
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Colfosceril; Cetyl Alcohol; Tyloxapol
• Cyclizine
• Cyclosporine
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Deferasirox
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Promethazine
• Diclofenac
• Diclofenac; Misoprostol
• Diflunisal
• Dimenhydrinate
• Diphenhydramine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Doravirine; Lamivudine; Tenofovir disoproxil fumarate
• Doxacurium
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Emtricitabine
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Emtricitabine; Tenofovir alafenamide
• Emtricitabine; Tenofovir disoproxil fumarate
• Enflurane
• Entecavir
• Esomeprazole; Naproxen
• Ethacrynic Acid
• Etodolac
• Etomidate
• Famotidine; Ibuprofen
• Fenoprofen
• Fluphenazine
• Flurbiprofen
• Foscarnet
• Furosemide
• Gallium
• Gallium Ga 68 Dotatate
• Ganciclovir
• Ginger, Zingiber officinale
• Gold
• Halothane
• Hyaluronidase, Recombinant; Immune Globulin
• Hydrocodone; Ibuprofen
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibandronate
• Ibuprofen
• Ibuprofen lysine
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Immune Globulin IV, IVIG, IGIV
• Indomethacin
• Inotersen
• Iohexol
• Iopamidol
• Iopromide
• Ioversol
• Isoflurane
• Isosulfan Blue
• Ketamine
• Ketoprofen
• Ketorolac
• Lamivudine; Tenofovir Disoproxil Fumarate
• Lansoprazole; Naproxen
• Magnesium Salicylate
• Mannitol
• Meclizine
• Meclofenamate Sodium
• Mefenamic Acid
• Meloxicam
• Meperidine; Promethazine
• Mesoridazine
• Methohexital
• Mivacurium
• Nabumetone
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Neuromuscular blockers
• Non-Ionic Contrast Media
• Nonsteroidal antiinflammatory drugs
• Oral Contraceptives
• Oxaprozin
• Pamidronate
• Pancuronium
• Pentamidine
• Perphenazine
• Perphenazine; Amitriptyline
• Phenylephrine; Promethazine
• Piroxicam
• Polymyxin B
• Polymyxins
• Poractant Alfa
• Promethazine
• Propofol
• Pyridostigmine
• Rapacuronium
• Rocuronium
• Rofecoxib
• Salicylates
• Salsalate
• Scopolamine
• Sevoflurane
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Streptozocin
• Succinylcholine
• Sulindac
• Surfactants
• Tacrolimus
• Telavancin
• Telbivudine
• Tenofovir Alafenamide
• Tenofovir, PMPA
• Thioridazine
• Tolmetin
• Torsemide
• Trifluoperazine
• Trimethobenzamide
• Tubocurarine
• Urea
• Valacyclovir
• Valdecoxib
• Valganciclovir
• Vancomycin
• Vecuronium
• Warfarin
• Zalcitabine, ddC
• Zoledronic Acid