药品详细
Amikacin(阿米卡星)
化学结构式图
中文名
阿米卡星
英文名
Amikacin
分子式
C22H43N5O13
化学名
(2S)-4-amino-N-[(1R,2S,3S,4R,5S)-5-amino-2-{[(2S,3R,4S,5S,6R)-4-amino-3,5-dihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy}-4-{[(2R,3R,4S,5S,6R)-6-(aminomethyl)-3,4,5-trihydroxyoxan-2-yl]oxy}-3-hydroxycyclohexyl]-2-hydroxybutanamide
分子量
Average: 585.6025
Monoisotopic: 585.285736487
Monoisotopic: 585.285736487
CAS号
37517-28-5
ATC分类
D06A 未知;J01G 未知;S01A 抗感染药
药物类型
small molecule
阶段
approved
商品名
Amicacin;Amiglyde-V;Amikavet;Amikin;Briclin;
同义名
amikacin;Amikacin Base;Amikacin Dihydrate;Amikacin Sulfate;Amikacina [INN-Spanish];Amikacine [INN-French];Amikacinum [INN-Latin];ANTIBIOTIC BB-K8;BB-K8;
基本介绍
Amikacin is a semi-synthetic aminoglycoside antibiotic derived from kanamycin A. Similar to other aminoglycosides, amikacin disrupts bacterial protein synthesis by binding to the 30S ribosome of susceptible organisms. Binding interferes with mRNA binding and tRNA acceptor sites leading to the production of non-functional or toxic peptides. Other mechanisms not fully understood may confer the bactericidal effects of amikacin. Amikacin is also nephrotoxic and ototoxic.
生产厂家
- Abbott laboratories
- Abbott laboratories hosp products div
- Apothecon inc div bristol myers squibb
- Astrazeneca lp
- Baxter healthcare corp anesthesia and critical care
- Bedford laboratories div ben venue laboratories inc
- Hospira inc
- Teva parenteral medicines inc
封装厂家
参考
| Synthesis Reference | Not Available |
| General Reference |
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剂型
规格
化合物类型
| Type | small molecule |
| Classes |
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| Substructures |
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适应症
antibacterials 抗细菌;
药理
| Indication | For short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria, including Pseudomonas species, Escherichia coli, species of indole-positive and indole-negative Proteus, Providencia species, Klebsiella-Enterobacter-Serratia species, and Acinetobacter (Mima-Herellea) species. Amikacin may also be used to treat Mycobacterium avium and Mycobacterium tuberculosis infections. | ||||||
| Pharmacodynamics | Amikacin is an aminoglycoside antibiotic. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit, causing misreading of t-RNA, leaving the bacterium unable to synthesize proteins vital to its growth. Aminoglycosides are useful primarily in infections involving aerobic, Gram-negative bacteria, such as Pseudomonas, Acinetobacter, and Enterobacter. In addition, some mycobacteria, including the bacteria that cause tuberculosis, are susceptible to aminoglycosides. Infections caused by Gram-positive bacteria can also be treated with aminoglycosides, but other types of antibiotics are more potent and less damaging to the host. In the past the aminoglycosides have been used in conjunction with penicillin-related antibiotics in streptococcal infections for their synergistic effects, particularly in endocarditis. Aminoglycosides are mostly ineffective against anaerobic bacteria, fungi and viruses. | ||||||
| Mechanism of action | Aminoglycosides like Amikacin "irreversibly" bind to specific 30S-subunit proteins and 16S rRNA. Amikacin inhibits protein synthesis by binding to the 30S ribosomal subunit to prevent the formation of an initiation complex with messenger RNA. Specifically Amikacin 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. | ||||||
| Absorption | Rapidly absorbed after intramuscular administration. Rapid absorption occurs from the peritoneum and pleura. Poor oral and topical absorption. Poorly absorbed from bladder irrigations and intrathecal administration. | ||||||
| Volume of distribution |
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| Protein binding | 0-11% | ||||||
| Metabolism |
Not Available
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| Route of elimination | Amikacin is excreted primarily by glomerular filtration. | ||||||
| Half life | 2-3 hours | ||||||
| Clearance |
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| Toxicity | Mild and reversible nephrotoxicity may be observed in 5 - 25% of patients. Amikacin accumulates in proximal renal tubular cells. Tubular cell regeneration occurs despite continued drug exposure. Toxicity usually occurs several days following initiation of therapy. May cause irreversible ototoxicity. Otoxocity appears to be correlated to cumulative lifetime exposure. Drug accumulation in the endolymph and perilymph of the inner ear causes irreversible damage to hair cells of the cochlea or summit of ampullar cristae in the vestibular complex. High frequency hearing is lost first with progression leading to loss of low frequency hearing. Further toxicity may lead to retrograde degeneration of the 8th cranial (vestibulocochlear) nerve. Vestibular toxicity may cause vertigo, nausea, vomiting, dizziness and loss of balance. | ||||||
| Affected organisms |
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| Pathways |
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理化性质
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| State | solid | ||||||||||||||||||||||||||||||||||||||||||
| Experimental Properties |
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| Predicted Properties |
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药物相互作用
| Drug | Interaction |
|---|---|
| Atracurium | The agent increases the effect of muscle relaxant |
| Bumetanide | Increased ototoxicity |
| Cefalotin | Increased risk of nephrotoxicity |
| Cefamandole | Increased risk of nephrotoxicity |
| Cefazolin | Increased risk of nephrotoxicity |
| Cefonicid | Increased risk of nephrotoxicity |
| Cefoperazone | Increased risk of nephrotoxicity |
| Ceforanide | Increased risk of nephrotoxicity |
| Cefotaxime | Increased risk of nephrotoxicity |
| Cefotetan | Increased risk of nephrotoxicity |
| Cefoxitin | Increased risk of nephrotoxicity |
| Cefradine | Increased risk of nephrotoxicity |
| Ceftazidime | Increased risk of nephrotoxicity |
| Ceftizoxime | Increased risk of nephrotoxicity |
| Ceftriaxone | Increased risk of nephrotoxicity |
| Cefuroxime | Increased risk of nephrotoxicity |
| Cephapirin | Increased risk of nephrotoxicity |
| Cisplatin | Increased risk of nephrotoxicity |
| Colistimethate | Aminoglycosides may enhance the nephrotoxic effect of Colistimethate. Aminoglycosides may enhance the neuromuscular-blocking effect of Colistimethate. Due to the potential for additive or synergistic toxicities (including both nephrotoxicity and neuromuscular blockade) between colistimethate and the aminoglycoside antibiotics, this combination should be avoided whenever possible. If these agents must be used together, patients' renal and neuromuscular function should be monitored closely. |
| Doxacurium chloride | The agent increases the effect of muscle relaxant |
| Ethacrynic acid | Increased ototoxicity |
| Furosemide | Increased ototoxicity |
| Metocurine | The agent increases the effect of muscle relaxant |
| Mivacurium | The agent increases the effect of muscle relaxant |
| Pancuronium | The agent increases the effect of muscle relaxant |
| Pipecuronium | The agent increases the effect of muscle relaxant |
| Rocuronium | The agent increases the effect of muscle relaxant |
| Succinylcholine | The agent increases the effect of muscle relaxant |
| Tacrolimus | Additive renal impairment may occur during concomitant therapy with aminoglycosides such as Amikacin. Use caution during concomitant therapy. |
| Thalidomide | Thalidomide increases the renal toxicity of the aminoglycoside |
| Ticarcillin | Ticarcillin may reduce the serum concentration of Amikacin. Ticarcillin may inactivate Amikacin in vitro and the two agents should not be administered simultaneously through the same IV line. |
| Torasemide | Increased ototoxicity |
| Tubocurarine | The agent increases the effect of muscle relaxant |
| Vecuronium | The agent increases the effect of muscle relaxant |
食物相互作用
Not Available
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