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Pronunciation |
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(koe
lis ti METH
ate) |
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U.S. Brand
Names |
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Coly-Mycin® M
Parenteral |
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Generic
Available |
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No |
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Synonyms |
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Colistimethate Sodium |
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Pharmacological Index |
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Antibiotic, Miscellaneous |
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Use |
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Treatment of infections due to sensitive strains of certain gram-negative
bacilli which are resistant to other antibacterials or in patients allergic to
other antibacterials |
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Pregnancy Risk
Factor |
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B |
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Contraindications |
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Hypersensitivity to colistimethate or any component |
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Warnings/Precautions |
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Use with caution in patients with pre-existing renal
disease |
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Adverse
Reactions |
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1% to 10%: Respiratory arrest, nephrotoxicity, GI upset, vertigo, slurring of
speech, urticaria |
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Drug
Interactions |
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Other nephrotoxic drugs, neuromuscular blocking agents |
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Stability |
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Freshly prepare any infusion and use for no longer than 24
hours |
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Mechanism of
Action |
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Hydrolyzed to colistin, which acts as a cationic detergent which damages the
bacterial cytoplasmic membrane causing leaking of intracellular substances and
cell death |
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Pharmacodynamics/Kinetics |
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Distribution: Widely distributed, except for CNS, synovial, pleural, and
pericardial fluids
Half-life: 1.5-8 hours; may be as high as 2-3 days in anuric patients
Elimination: Excreted primarily unchanged in urine
Peak: About 2 hours |
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Usual Dosage |
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Children and Adults:
Inhalation: 75 mg in 3 mL NS (4 mL total) via nebulizer twice daily
Dosing interval in renal impairment: Adults:
Scr 0.7-1.2 mg/dL: 100-125 mg 2-4 times/day
Scr 1.3-1.5 mg/dL: 75-115 mg twice daily
Scr 1.6-2.5 mg/dL: 66-150 mg once or twice daily
Scr 2.6-4 mg/dL: 100-150 mg every 36 hours |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Nursing
Implications |
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Freshly prepare and use within 24 hours |
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Dosage Forms |
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Powder for injection, lyophilized: 150 mg |
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References |
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Bauldoff GS, Nunley DR, Manzetti JD, et al,
"Use of Aerosolized Colistin in Cystic Fibrosis Patients Awaiting Lung Transplantation,"
Transplantation, 1997, 64(5):748-52.
Conway SP, Pond MN, Watson A, et al,
"Intravenous Colistin Sulphomethate in Acute Respiratory Exacerbations in Adult Patients With Cystic Fibrosis,"
Thorax, 1997, 52(11):987-93.
Jensen T, Pederson SS, Garne S, et al,
"Colistin Inhalation Therapy in Cystic Fibrosis Patients with Chronic Pseudomonas aeruginosa Lung Infection,"
J Antimicrob Chemother, 1987, 19(6):831-8.
Zylberberg H, Vargaftig J, Barbieux C, et al,
"Prolonged Efficiency of Secondary Prophylaxis with Colistin Aerosols for Respiratory Infection Due to Pseudomonas aeruginosa in Patients Infected With Human Immunodeficiency Virus,"
Clin Infect Dis, 1996, 23(3):641-3.
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