In the appointment of tobramycin inhalation in the form of its adsorption and bioavailability low. One of the symptoms of aerosol overdose is severe hoarseness.
For the diagnosis of overdosing is necessary to control the concentration of tobramycin in the blood plasma. With an overdose of the drug should be lifted immediately and carry out monitoring of renal function, taking into cytomel reviews account changes in excretion of tobramycin when it interacts with other drugs. No specific antidote.
Interaction with other drugs
should be avoided joint and / or sequential use Toby with other medicinal products with nephrotoxic or ototoxic potential.
Certain diuretics may increase the toxicity of the aminoglycoside antibiotic by varying concentrations in serum and tissues. Should not be used in conjunction with furosemide, urea or mannitol.
Other medicines, which reportedly increases the potential toxicity of parenterally administered aminoglycosides include: Amphotericin B, cephalothin, tacrolimus, polymyxins (risk of nephrotoxicity of growth);platinum compounds (growth risk of nephrotoxicity and ototoxicity); anticholinesterase drugs, botulinum toxin (the impact on the neuromuscular system).
When inhaled drugs bronchospasm may occur. The first dose should be Toby breathe under the supervision of a doctor, taking pre-bronchodilator if this drug is currently assigned to the patient. Before and after inhalation to be measured lung . If the symptoms are induced bronchoconstriction treatment in a patient not taking a bronchodilator, the test should be repeated with the use of a bronchodilator drug. Signs of bronchoconstriction in the presence of a bronchodilator may indicate allergic response. If you are planning an allergic reaction, discontinue receiving . Bronchospasm should be treated in accordance with clinical indications accordingly.
Toby should be used with cytomel reviews extreme caution in patients with neuromuscular disorders such as parkinsonism or other conditions characterized by myasthenia, including myasthenia gravis, as aminoglycosides may aggravate muscle weakness due to potential effects on neuromuscular function, similar to the action of curare poison.
For patients with known or suspected renal dysfunction should be used with caution and check the concentration of tobramycin in serum. Assessment of renal function should be performed before treatment and then every 6 full cycles of therapy Toby (180 days of therapy sprayed aminoglycoside) should be re-evaluated level of urea and creatinine. If there are any signs of nephrotoxicity tobramycin therapy should be stopped as long as the minimum serum concentration dropped below 2 mg / ml. After that, at the discretion of the doctor treatment can be resumed. Patients receiving concomitant parenteral aminoglycoside therapy others must undergo appropriate medical examination, taking into account the risk of cumulative (cumulative) toxicity.
Ototoxicity, vestibular and auditory toxicity observed with parenteral use of aminoglycosides. Ataxia, dizziness may be symptoms of vestibular ototoxicity. Auditory toxicity, determined on the basis of complaints of hearing loss and audiometric measurements, in controlled clinical trials, was not observed. It is necessary to take into account the potential for aminoglycosides to cause vestibular and cochlear (snail) toxicity and investigate auditory function before starting therapy, especially in patients with a predisposition to the risk due to previous prolonged systemic therapy with aminoglycosides.Audiometry should be performed in patients with any hearing impairment during treatment cytomel reviews and in patients with a high risk of developing such complications.
Inhalation of sprays may cause the cough reflex.
There is theoretically possible risk that patients treated with inhaled tobramycin may aeruginosa resistance to intravenous tobramycin.
The solution for inhalation of 300 mg / 5 ml in 5 ml ampoule of low density polyethylene.
14 vials in a plastic tray, placed in a bag. 4 package with instruction on the medical application in a carton box.
Store at 2-8 ° C in a dark place.
Store in original container. The contents cytomel reviews of the whole ampoule should be used immediately after opening.
After removal from the refrigerator, or in the absence of a refrigerator bags with the drug (intact or opened) may be stored at a temperature of 25 ° C for 28 days.
Keep out of the reach of children.