|1. TYPE OF DRUG- Neomycin|
|Neomycin is an antibiotic that fights bacteria in the body.
|2. INDICATIONS (USE)- Neomycin|
|Topical uses include treatment for superficial eye infections caused by susceptible bacteria (used in combination with other antiinfectives), treatment of otitis externa caused by susceptible bacteria, treatment or prevention of bacterial infections in skin lesions, and use as a continuous short-term irrigant or rinse to prevent bacteriuria and gram negative rod bacteremia in abacteriuric patients with indwelling catheters. May be used orally to treat hepatic encephalopathy, as a perioperative prophylactic agent, and as an adjunct to fluid and electrolyte replacement in the treatment of diarrhea caused to enteropathogenic E. coli (EPEC).
|3. MECHANISM OF ACTION (MOA)- Neomycin|
|Aminoglycosides like neomycin “irreversibly” bind to specific 30S-subunit proteins and 16S rRNA. Specifically neomycin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with decoding site in the vicinity of nucleotide 1400 in 16S rRNA of 30S subunit. This region interacts with the wobble base in the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides and the breakup of polysomes into nonfunctional monosomes.
|4. ROUTES OF ADMINISTRATION- Neomycin|
|5. ONSET OF EFFECT OR ACTION- Neomycin|
|6. DOSAGE (DOSING INFORMATION)- Neomycin|
|PO:Adults :0.25-1 gm QID.
Children : 50-100 mg/kg/day in 3-4 divided doses.
|7. HALF LIFE (DURATION OF ACTION)- Neomycin|
|2 to 3 hours
|8. ADVERSE EFFECTS OR SIDE EFFECTS – Neomycin|
|drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting; swelling, weight gain, feeling short of breath; weak or shallow breathing; or. severe stomach cramps, diarrhea that is watery or bloody.|
|9. CONTRAINDICATIONS – Neomycin|
|Neomycin Sulfate oral preparations are contraindicated in the presence of intestinal obstruction and in individuals with a history of hypersensitivity to the drug.
Patients with a history of hypersensitivity or serious toxic reaction to other aminoglycosides may have a cross-sensitivity to neomycin.
Neomycin Sulfate oral preparations are contraindicated in patients with inflammatory or ulcerative gastrointestinal disease because of the potential for enhanced gastrointestinal absorption of neomycin.
|10. DRUG INTERACTIONS – Neomycin|
|Caution should be taken in concurrent or serial use of other neurotoxic and/or nephrtoxic drugs because of possible enhancement of the nephrotoxicity and/or ototoxicity of neomycin.
Caution should also be taken in concurrent or serial use of other aminoglycosides and polymyxins because they may enhance neomycin’s nephrotoxicity and/or ototoxicity and potentiate Neomycin Sulfate’s neuromuscular blocking effects.
Oral neomycin inhibits the gastrointestinal absorption of penicillin V, oral vitamin B-12, methotrexate and 5-fluorouracil. The gastrointestinal absorption of digoxin also appears to be inhibited. Therefore, digoxin serum levels should be monitored.
Oral Neomycin Sulfate may enhance the effect of coumarin in anticoagulants by decreasing vitamin K availability.
|11. EXCRETION- Neomycin|
|The small absorbed fraction is rapidly distributed in the tissues and is excreted by the kidney in keeping with the degree of kidney function.|