Kanamycin

Kanamycin is an Antibiotic agent belonging to Aminoglycoside

Kanamycin is used to treat serious bacterial infections in many different parts of the body.

Kanamycin is poorly absorbed from the GI tract (<1%) but may be significantly increased if the GI mucosa is inflamed or ulcerated and get rapidly absorbed (IM) and get distributed into most body tissues and fluids. Crosses the placenta (IM) and enters breast milk. The Volume of distribution was Approx 0.3 L/kg and get excreted Via urine as unchanged drug. Plasma half-life: Approx 3 hr.

Kanamycin shows common side effects like Headache, dizziness, Diarrhea, sore throat, runny nose, sneezing, joint pain, etc.

Kanamycin is available in the form of injection

Kanamycin is available in India, Germany, Canada, Italy.

Kanamycin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with decoding site in the vicinity of nucleotide 1400 in 16S rRNA of 30S subunit. This region interacts with the wobble base in the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides and the breakup of polysomes into nonfunctional monosomes.

Kanamycin is available in the form of injection.

IV: Infuse over 60 minutes; do not infuse by rapid or bolus intravenous infusion.

Kanamycin is used to treat serious bacterial infections in many different parts of the body.

Kanamycin is an antibiotic. It stops bacterial growth by preventing synthesis of essential proteins required by bacteria to carry out vital functions.

Kanamycin is approved for use in the following clinical indications

Kanamycin is used to treat serious bacterial infections in many different parts of the body.

Kanamycin is available in various strengths as 500 mg, 750 mg and 1 gm. 

Kanamycin is available in the form of  injection.

• General

Neurotoxic and nephrotoxic antibiotics may be almost completely absorbed from body surfaces (except the urinary bladder) after local irrigation and after topical application during surgical procedures. The potential toxic effects of antibiotics administered in this fashion (oto- and nephrotoxicity, neuromuscular blockade, respiratory paralysis) should be considered.

Increased nephrotoxicity has been reported following concomitant administration of aminoglycoside antibiotics with some cephalosporins.

Aminoglycosides should be used with caution in patients with neuromuscular disorders such as myasthenia gravis, Parkinsonism, or infant botulism, since these drugs may aggravate muscle weakness because of their potential curare-like effect on neuromuscular function.

Kanamycin may cause liver problems, and using it with substantial quantities of ethanol may increase that risk.

• Kanamycin and its active metabolite (14-hydroxyKanamycin ) are present in breast milk.

• Data related to the presence of Kanamycin in breast milk is available from 12 breastfeeding women taking oral Kanamycin 250 mg twice daily for puerperal infections. Serial blood and milk samples were obtained at timed intervals. Both Kanamycin and its active metabolite, 14-hydroxyKanamycin , were present in breast milk. The mean peak Kanamycin milk concentration was 0.85 mg/L ± 0.12 mg/L at 2.2 ± 0.2 hours after the dose; peak 14-hydroxyKanamycin concentrations were 0.63 mg/L ± 0.08 mg/L at 2.8 ± 0.3 hours after the dose. The half-lives of Kanamycin and 14-hydroxyKanamycin in breast milk were 4.3 ± 0.3 hours and 9 ± 1.2 hours, respectively

Immediate release: Food delays rate, but not extent of absorption; Extended release: Food increases Kanamycin AUC by ~30% relative to fasting conditions. Management: Administer immediate release products without regard to meals. Administer extended release products with food.

• Common Adverse effects

Headache, Ototoxicity, Gastrointestinal disturbance, Anaphylactic reaction, Hypersensitivity reaction

• Less Common Adverse effects:

CNS effects including seizures, increased intracranial pressure, lightheadedness, dizziness, tremor; psychotic reactions (e.g. hallucinations, nervousness, delirium), sensory or sensorimotor peripheral neuropathy, prolonged QT interval, blood glucose disturbances (hypo-/hyperglycemia), phototoxicity, superinfection (prolonged use), bronchospasm

• Rare Adverse effects

Hepatitis, jaundice. Injury, poisoning and procedural complications: Infusion site reaction (e.g. pain, reddening), phlebitis. Investigations: Increased hepatic enzymes (ALT/AST, alkaline phosphatase, GGT), decreased forced expiratory volume.

Additive nephrotoxic and neurotoxic effects w/ polymyxin B, bacitracin, colistin, amphotericin B, cisplatin, vancomycin, and other aminoglycosides (e.g. paromomycin). Enhanced toxicity w/ potent diuretics (e.g. ethacrynic acid, furosemide, meralluride Na, Na mercaptomerin, or mannitol). Increased risk of nephrotoxicity w/ cephalosporins. May potentiate the effects of succinylcholine and non-depolarising muscle relaxants (e.g. rocuronium). NSAIDs may increase concentrations of kanamycin.

The common side effects of Kanamycin include the following Diarrhea.

• Increased amount of gas
• Light-colored, frothy, or fatty-appearing stools
• Skin rash
• Sudden loss of weight
• Vomiting

Symptoms: Abdominal pain, vomiting, nausea, and diarrhoea.

Management: Supportive treatment. Initiate prompt elimination of unabsorbed drugs.

Pharmacodynamic

Kanamycin is an aminoglycoside antibiotic. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit, causing misreading of t-RNA, leaving the bacterium unable to synthesize proteins vital to its growth. Aminoglycosides are useful primarily in infections involving aerobic, Gram-negative bacteria, such as Pseudomonas, Acinetobacter, and Enterobacter. In addition, some mycobacteria, including the bacteria that cause tuberculosis, are susceptible to aminoglycosides. Infections caused by Gram-positive bacteria can also be treated with aminoglycosides, but other types of antibiotics are more potent and less damaging to the host. In the past the aminoglycosides have been used in conjunction with penicillin-related antibiotics in streptococcal infections for their synergistic effects, particularly in endocarditis. Aminoglycosides are mostly ineffective against anaerobic bacteria, fungi and viruses.

Pharmacokinetics

• Absorption

Kanamycin is rapidly absorbed after intramuscular injection and peak serum levels are generally reached within approximately one hour. Poor oral and topical absorption except with severe skin damage.

• Distribution

Distributed into most body tissues and fluids. Crosses the placenta (IM) and enters breast milk. Volume of distribution: Approx 0.3 L/kg.

• Excretion

Via urine as unchanged drug. Plasma half-life: Approx 3 hr.

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1364710/
• https://reference.medscape.com/drug/colestid-Kanamycin -342452
• https://go.drugbank.com/drugs/DB00375
• https://www.sciencedirect.com/topics/medicine-and-dentistry/Kanamycin
• https://europepmc.org/article/med/6988203