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|Chloramphenicol |
Drugs search, click the first letter of a drug name: | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9 Home ChloramphenicolPronouncation: (KLOR-am-FEN-ih-kahl)Class: Antibiotic, Anti-infective agent Trade Names: Mechanism of ActionPharmacologyInterferes with or inhibits microbial protein synthesis. PharmacokineticsAbsorptionOralChloramphenicol is rapidly absorbed and 75% to 90% bioavailable. C max is 11.2 mcg/mL. T max is 1 hr. Therapeutic concentrations are 10 to 20 mcg/mL (peak) and 5 to 10 mcg/mL (trough). DistributionChloramphenicol diffuses rapidly; highest concentrations are found in the liver and kidney and lowest concentrations are found in the brain and CSF. It also is found in pleural and ascitic fluid, saliva, milk, and aqueous and vitreous humors. It crosses the placenta and is about 60% protein bound. MetabolismChloramphenicol or sodium succinate is hydrolyzed to active chloramphenicol base. Elimination68% to 99% is excreted in the urine. 8% to 12% is excreted as free chloramphenicol; the remainder is excreted as inactive metabolites. Small amounts are found in bile and feces. The t ½ is about 1.5 to 4 hr. Special PopulationsRenal Function ImpairmentMetabolism and excretion may be reduced. Dosage adjustment is recommended. Hepatic Function ImpairmentMetabolism and excretion may be reduced. Dosage adjustment is recommended. Indications and UsageTreatment of infections caused by susceptible strains of specific microorganisms; serious systemic infections for which less potentially dangerous drugs are ineffective or contraindicated. ContraindicationsTrivial infections (eg, colds, influenza, throat infections) or infections other than indicated; prophylaxis of systemic bacterial infections; hypersensitivity to product. Dosage and AdministrationSystemic InfectionsAdults IV 50 mg/kg/day in divided doses q 6 hr; may require up to 100 mg/kg/day initially for infections caused by moderately resistant organisms. ChildrenIV 50 mg/kg/day in 4 doses q 6 hr; 50 to 100 mg/kg/day for severe infections (eg, bacteremia, meningitis). Infants and Children with immature metabolic processesIV 25 mg/kg/day. NewbornsIV Usually 25 mg/kg/day in 4 doses q 6 hr. Newborns over 14 days (over 2 kg)IV up to 50 mg/kg/day in 4 doses q 6 hr. Newborns under 2 kg and birth to 14 days (over 2 kg)IV 25 mg/kg qd. General Advice
Storage/StabilityStore reconstituted solution below 30°C (86°F). Prior to reconstitution, refrigerate at 2° to 8°C (36° to 46°F). Protect from light. Remove from refrigerator for dispensing; discard after 21 days. Drug InteractionsAgents that suppress bone marrowRisk or severity of bone marrow suppression may be increased. AnticoagulantsMay enhance anticoagulation action. BarbituratesMay reduce effectiveness of chloramphenicol while barbiturate effects may be enhanced; effects may last days after barbiturates are withdrawn. Ferrous saltsMay increase serum iron levels. Hydantoins (eg, phenytoin)May increase serum hydantoin levels, with possible toxicity; chloramphenicol levels may increase or decrease. RifampinMay reduce chloramphenicol serum levels; effect may last days after rifampin is withdrawn. SulfonylureasMay cause clinical manifestations of hypoglycemia. Vitamin B 12May decrease hematologic effects of vitamin B 12 in patients with pernicious anemia. Laboratory Test InteractionsNone well documented. Adverse ReactionsCNSHeadache; mental confusion; delirium; mild depression; optic neuritis; peripheral neuritis. GIDiarrhea; nausea; vomiting; glossitis; stomatitis; enterocolitis. HematologicBone marrow depression; aplastic anemia; hypoplastic anemia; thrombocytopenia; granulocytopenia. MiscellaneousHypersensitivity reactions (eg, fever, rash, angioedema, urticaria, anaphylaxis); Gray syndrome. Precautions
PregnancyCategory C . LactationExcreted in breast milk. ChildrenUse drug with caution and in reduced dosages in premature and term infants and children with immature metabolic functions to avoid Gray syndrome toxicity (eg, toxic and potentially fatal reaction in premature infants and newborns). Symptoms of Gray syndrome generally appear in this sequence: abdominal distention with or without emesis; progressive pallid cyanosis; vasomotor collapse, frequently accompanied by irregular respiration; death within a few hours of onset (death occurs in 40% of patients within 2 days of initial symptoms). Other initial symptoms of Gray syndrome may include refusal to suck, loose green stools, flaccidity, ashen gray color, decreased temperature, and refractory lactic acidosis. Renal FunctionExcessive blood levels of drug may occur; dosage adjustment may be required. Hepatic FunctionExcessive blood levels of drug may occur; dosage adjustment may be required. Pre-existing liver dysfunction may be significant risk factor for Gray syndrome. Special Risk PatientsUse drug with caution in patients with acute intermittent porphyria or G-6-PD deficiency. SuperinfectionUse of antibiotics may result in bacterial or fungal overgrowth. Blood dyscrasiasSerious and fatal blood dyscrasias can occur. OverdosageSymptomsNausea, vomiting, unpleasant taste, diarrhea, bone marrow suppression. Patient Information
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