toe-bra-MYE-sin
REMS
Pseudomonas aeruginosa
.Spectrum:
Absorption: Well absorbed after IM administration. IV administration results in complete bioavailability. Low absorption follows administration by inhalation.
Distribution: Widely distributed throughout extracellular fluid; crosses the placenta; small amounts enter breast milk. Poor penetration into CSF.
Half-Life: Neonates: 2–11 hr; Infants: 3–5 hr; Children: 1–3 hr; Adolescents: 0.5–2.5 hr; Adults: 2–4 hr (↑ in renal impairment to 5–70 hr).
| ROUTE | ONSET | PEAK | DURATION |
| IM | rapid | 30–90 min | 6–24 hr |
| IV | rapid | end of infusion‡ | 6–24 hr |
‡All parenterally administered aminoglycosides.
‡Postdistribution peak occurs 30 min after the end of a 30-min infusion and 15 min after the end of a 1-hr infusion.
Contraindicated in:
Use Cautiously in:
EENT: ototoxicity (vestibular and cochlear),
Inhalation only
tinnitus, voice alterationGI: CLOSTRIDIUM DIFFICILE-ASSOCIATED DIARRHEA (CDAD)
GU: nephrotoxicity
F and E: hypomagnesemia
MS: muscle paralysis (high parenteral doses)
Resp:
Inhalation only
bronchospasm, wheezingMisc: hypersensitivity reactions
Drug-drug:
Inhaln
(Adults and Children ≥6 yr): Nebulizer solution—300 mg twice daily for 28 days, then off for 28 days, then repeat cycle; Powder for inhalation—Inhale contents of four 28–mg capsules twice daily for 28 days, then off for 28 days, then repeat cycle.Renal Impairment
Lab Test Considerations:
Toxicity and Overdose:
IV Administration:
NDC Code