Streptomycin

Streptomycin is an aminoglycoside antibiotic. It has a hexose ring, streptidine to which various amino sugars are attached by glycosidic linkages. Streptomycin is the first of the aminoglycoside antibiotic and was isolated from a strain of Streptomyces griseus by Waksman and his associates in 1944. Aminoglycoside frequently exibit synergism with a beta lactam antibiotc or vancomycin. In combination they eradicate organism more rapidly than a single agent. Aminoglycosides are polycations and their polarity accounts for their pharmakokinetic peopertie. Streptomycin is effective against a large variety of aerobic gram negative bacilli an some gram positive bacteria including mycobacteria. The use of Streptomycin is now limited because of the emergence of resistance. Antibiotics require constant drug level in body for therapeutic effect. This is achieved by taking the drug at regular intervals of time throughout the day and night as prescribed. Streptomycin is important to take the drug for the full time period as prescribed, discontinuation of the drug, may result in ineffective treatment.

Brands
POLYBIOTIC POLYBIOTIC STREPTOMYCIN
Adult Dose
Dose: 15 mg/ kg
Single Dose: 15 (15)
Frequency: 24 hourly
Route: IM
Instructions: Maximum dose 1g/day
Neonatal
Dose: 15 mg/kg
Single Dose: 15 (15)
Frequency: 12 hourly
Route: Intra Muscular
Instructions: -
Paedriatic
Dose: 15 mg/kg
Single Dose: 15 (15)
Frequency: 12 hourly
Route: Intra Muscular
Instructions: -
Characteristics
. It is of Semi Synthetic origin and belongs to Aminoglycosides. It belongs to Antibacterial (Proetin synthesis inhibitor) pharmacological group on the basis of mechanism of action. The Molecular Weight of Streptomycin is 581.60. Its pKa is 4.5 - 7.0.
Contraindications
Streptomycin is contraindicated in conditions like Myasthenia gravis,Renal diseases,Ear infection.
Effects
The severe or irreversible adverse effects of Streptomycin, which give rise to further complications include Deafness.Streptomycin produces potentially life-threatening effects which include Agranulocytosis, Aplastic Anemia. which are responsible for the discontinuation of Streptomycin therapy.The signs and symptoms that are produced after the acute overdosage of Streptomycin include Renal failure, Hemolytic anemia.The symptomatic adverse reactions produced by Streptomycin are more or less tolerable and if they become severe, they can be treated symptomatically, these include Vertigo, Ataxia, Tinnitus, Urinary retensionX, Pain, Giddiness, Nystagmus, Pleocytosis, Neck pain.
Indications
Streptomycin is primarily indicated in conditions like Bacterial infections, Oliguria due to renal failure, Plague, Tuberculosis, Tularemia.
Interactions
Streptomycin is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAmphotericin BAtracurium (Besylate)Coadministartoin results in severe respiratory depression by decreasing the release of acetylcholine at neuromuscular junction by interfering with calcium influx.MajorCoadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary. Coadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary.Cyclosporin AConcurrent use may cause toxicities to the kidneys.Ethacrynic AcidFloxacillin (Na)FludarabineFludarabine may increase the actions and side effects of Streptomycin.Frusemide or FurosemideFrusemide may enhance the adverse/toxic effect of Streptomycin. Specifically, nephrotoxicity and ototoxicity. ModerateMonitor for toxic effects of Streptomycin if Furosemide is initiated or the dose is increased. This is probably of most concern if Furosemide is administered in high doses for extended periods of time.GentamicinRespiratory paralysis and renal dysfunction risk is increased if this combination is used.MajorThis combination should be avoided.IbuprofenConcurrent use may cause toxicities to the kidneys.IndomethacinIndomethacin may increase the actions and side effects of Streptomycin.Pancuronium (Br)Streptomycin may increase the actions and side effects of Pancuronium (Br).Polymyxin B (Sulphate)Polymyxin B (Sulphate) may increase the actions and side effects of Streptomycin.Pyridostigmine (Br)Riboflavin (Vitamin B2)Streptomycin, erythromycin, tyrothricin and carbomycin antibiotic activity is reduced when given with riboflavin (vitamin B2)StreptozotocinConcurrent use may cause toxicities to the kidneys.ThiacetazoneVancomycin (HCl)Concurrent use may cause toxicities to the kidneys. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, patients suffering from Kidney dysfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store Below 40°C.
Warnings
Streptomycin should be used with caution in patients with history of kidney diseases, vertigo, hearing loss, myasthenia gravis, parkinsonisms. It should be used with caution in patients who are sensitive to aminoglycosides. Perform monthly blood counts test for atleast 4 months. Keep patients well hydrated to prevent chemical irritation or nephrotoxic reactions. Take appropriate measures in case of secondary infections.
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