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Polymax-B Injection
Incepta Pharmaceuticals Ltd.
Generic: Polymyxin B Sulfate
Medicine Overview of Polymax-B Injection 500000/Unit Injection
বাংলা
English
Indication
Susceptible infections, Meningitis
Administration
IV/IM/IT Preparation
IV: dilute 500,000 U in 300-500 mL D5W
IM: reconstitute vial with 2 mL SWI , NS, or procaine HCl 1% solution
Intrathecal (IT): reconstitute vial with10 mL NS; DO NOT use procaine HCl for IT
IV/IM Administration
IV: infuse over 60-90 min
IM: give deep into upper outer quadrant of gluteal muscles
Adult Dose
Intravenous
Susceptible infections
Adult: 15,000-25,000 U/kg daily by continuous IV drip or intermittent infusion 12 hrly at 60-120 min duration. Max: 2,000,000 U/day.
Intramuscular
Susceptible infections
Adult: 25,000-30,000 U/kg daily in divided doses 4-6 hrly. Max: 2,000,000 U/day.
Intrathecal
Meningitis
Adult: 50,000 U once daily for 3-4 days, then on alternate days for at least 2 wk after CSF cultures are negative and CSF glucose content is normal. Max: 2,000,000 U/day.
Child Dose
Intravenous
Susceptible infections
Adult: 15,000-25,000 U/kg daily by continuous IV drip or intermittent infusion 12 hrly at 60-120 min duration. Max: 2,000,000 U/day.
Child: 2 yr Same as adult dose but not routinely recommended due to pain at injection sites.
Intrathecal
Meningitis
Child: 2 yr Same as adult dose.
Renal Dose
Renal Impairment
CrCl >20 mL/minute: give 75-100% usual dose/day divided q12hr
CrCl 5-20 mL/minute: give 50% usual dose/day divided q12hr
CrCl <5 mL/minute: give 15% usual dose/day q12hr
Contraindication
Hypersensitivity to polymyxins; Concurrent use w/ nephrotoxic and/or neurotoxic drugs and neuromuscular blockers.
Mode of Action
Polymyxin B binds to phospholipids, alters permeability and disrupts the bacterial cytoplasmic membrane of mostly gm-ve organisms allowing leakage of intracellular constituents by binding to membrane phospholipids.
Precaution
Oliguria, myasthenia gravis, pregnancy, renal disease
Potential risk of nephrotoxicity and neurotoxicity
May inhibit neuromuscular transmission
Inactivated by strong acidic or alkaline solution
Discontinue if diminished urine output, rise in SCr or BUN, or signs of respiratory paralysis appear
Do not use IM routinely, particularly in peds, because of severe inj site pain
Side Effect
Frequency Not Defined
Anaphylactoid reactions with dyspnea and tachycardia
Eosinophilia
Fever
Nephrotoxicity
Neurotoxicity
Skin exanthemata
Urticaria
Pregnancy Category Note
Pregnancy Category: B: use when benefits outweigh risks
Lactation: use caution; no data
Interaction
Potentially Fatal: Additive neurotoxic or nephrotoxic effect w/ bacitracin, streptomycin, neomycin, kanamycin, gentamicin, tobramycin, amikacin, cephaloridine, paromomycin, viomycin, colistin. Increased risk of resp paralysis w/ neuromuscular blockers (e.g. anaesthetics, muscle relaxants).
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Polymax-B Injection
Incepta Pharmaceuticals Ltd.
