Kanamycin

Indications

Kanamycin is used for: Susceptible Infections

Adult Dose

Susceptible Infections IV Administration: 5-7.5 mg/kg/dose divided q8-12hr; not to exceed 15 mg/kg/day divided q6-12hr; administer slowly IM Administration: 5-7.5 mg/kg/dose divided q8-12hr; not to exceed 15 mg/kg/day IM divided q12hr at equally divided intervals; continuously high blood levels are desired; daily dose of 15 mg/kg may be given divided q6-8hr Aerosol: 250 mg q6-12hr by nebulization

Child Dose

Renal Dose

Renal Impairment CrCl 50-80 mL/min: give 60-90% of usual dose or give q8-12hr CrCl 10-50 mL/min: give 30-70% of usual dose or give q12hr CrCl <10 mL/min: give 20-30% of usual dose or give q24-48hr

Administration

IV Preparation For adults, IV infusions are prepared by adding 500 mg of kanamycin to 100-200 mL of usual IV infusion fluid such as NS or D5W or by adding 1 g of the drug to 200-400 mL of diluent IV/IM Administration Administer by deep IM injection, or IV infusion May administer by intraperitoneal instillation, irrigation, or inhalation Infuse over 30-60 min

Contra Indications

Documented hypersensitivity

Precautions

Auditory toxicity more common with kanamycin than with streptomycin and capreomycin; monthly audiometry is recommended while patients are being treated with this drug; vestibular toxicity is rare; renal toxicity occurs at a frequency similar to that of capreomycin; regular monitoring of serum creatinine recommended Neurotoxicity, manifested as both bilateral auditory and vestibular ototoxicity, can occur in patients with preexisting renal damage and in patients with normal renal function treated at higher doses and/or for periods longer than those recommended. High-frequency deafness usually occurs first and can be detected only by audiometric testing. Vertigo may occur and may be evidence of vestibular injury Aminoglycosides are potentially nephrotoxic. Risk is greater in patients with impaired renal function and in those who receive high doses or prolonged therapy. Rarely, nephrotoxicity may not become apparent until the first few days after cessation of therapy Use with caution in premature infants and neonates because of renal immaturity and the resulting prolongation of serum half-life of the drug

Pregnancy-Lactation

Pregnancy Category: D Lactation: usually compatible

Interactions

Adverse Effects

Side effects of Kanamycin : Frequency Not Defined Agranulocytosis Anorexia Diarrhea Dyspnea Edema Elevated BUN Enterocolitis Headache Incr salivation Muscle cramps Muscle weakness Nausea Nephrotoxicity Neurotoxicity Ototoxicity Pruritus Pseudotumor cerebri Rash Tinnitus Thrombocytopenia Tremor Vertigo Weakness

Mechanism of Action

Bactericidal Aminoglycoside contain 1 or 2 amino sugars linked to an aminocyclitol nucleus. Nucleus is 2-deoxystreptamine. Bactericidal and believed to inhibit protein synthesis by binding to 30 S ribosomal subunit.