Drug Index

Colistimethate

 
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Synonyms :

Colistin, Colistin Sulphate, Polymyxin E

Mechanism :

Colistimethate is a surface-active agent which penetrates into and disrupts the bacterial cell membrane. Colistimethate is polycationic and has both hydrophobic and lipophilic moieties. It interacts with the bacterial cytoplasmic membrane, changing its permeability. This effect is bactericidal. There is also evidence that polymyxins enter the cell and precipitate cytoplasmic components, primarily ribosomes.


Indication :

• MDR gram negative infection

• Pseudomonas lung infection in cystic fibrosis


Contraindications :

Hypersensitivity


Dosing :

Pseudomonas lung infection in cystic fibrosis:

Nebulised along with oral ciprofloxacin.

<1 year: 500,000 units 2 times daily.

1-10 year: 1 million units 2 times daily.

>10 years: 2 million units 2 times daily.

MDR gram negative infections: 2.5-5 mg/kg/day in 2-4 divided doses IV/IM.


Adverse Effect :

Dizziness, paresthesia, tingling sensation, neurotoxicity, nephrotoxicity, acute respiratory failure (inhalation route), respiratory tract paralysis.


Interaction :

Atracurium: Increases the effects of colistimethate.
Bacitracin: May increase nephrotoxicity or ototoxicity.
Skeletal Muscle Relaxants: Increases effects of colistimethate by pharmacodynamic synergism.


07/18/2019 01:44:30 Colistimethate
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