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Neomycyna - Skuteczny Lek na Pryszcze?
Czym jest neomycyna?
Neomycyna jest antybiotykiem aminoglikozydowym. Wykazuje działanie bakteriobójcze, co oznacza, że nie tylko hamuje proces rozwoju komórek bakteryjnych, ale i ostatecznie zwalcza drobnoustroje chorobotwórcze.
Przede wszystkim stosowana jest w przypadku obecności takich bakterii, jak:
- prątki gruźlicy,
- bakterie Gram-ujemne (szczególnie pałeczki, wyjątek stanowią jedynie Haemophilus),
- Staphylococcus aureus (czyli gronkowiec złocisty).
Neomycyna nie działa zaś na bakterię Pseudomonas aeruginosa (pałeczka ropy błękitnej). Oczywiście bardzo ważne dla skuteczności terapii antybakteryjnej jest stężenie neomycyny w miejscu zakażenia.
Substancję tę przyjmuje się z przepisu lekarza, jest na receptę. Jest dostępna w postaci tabletek, maści (na skórę lub do oczu) oraz aerozolu. Przyjmuje się ją dojelitowo (rzadziej) oraz stosuje miejscowo. Lek z neomycyną nie powinien wchłaniać się do krwi, ponieważ krążąc w krwiobiegu może być toksyczny dla ustroju.
Toxicity
Neomycin holds a pivotal role in the treatment of hepatic encephalopathy and perioperative prophylaxis. Due to the drug's potential for various toxicities, having a comprehensive medical history centered on renal, otological, and neurological conditions is imperative before considering a neomycin prescription. Patients should be well-informed about the advantages and potential risks of neomycin therapy. Furthermore, conducting baseline and regular laboratory assessments is essential to monitor for any indications of end-organ damage in patients.
The recommended course of action for patients receiving neomycin is as follows:
Physicians and advanced practice practitioners usually prescribe the medicine.The internist is responsible for determining the appropriate indication for neomycin in hepatic coma.
The surgeon is responsible for identifying the proper indication of neomycin in surgical prophylaxis.
A nephrologist consultation is necessary if the patient develops nephrotoxicity. An otorhinolaryngologist consultation should be initiated if the patient develops ototoxicity.A neurologist consultation is necessary if the patient develops neurotoxicity and neuromuscular blockade.
An intensivist is required for ICU care to determine the need for mechanical ventilation in severe toxicity.
Pharmacists assume responsibility for crucial aspects of patient care, including medication reconciliation, thorough assessment of potential drug interactions, patient counseling, verifying accurate drug dosing, and providing comprehensive responses to clinician inquiries.
Specially trained nursing staff are responsible for administering neomycin at the designated intervals, maintaining detailed records of patients, providing attentive care to hospitalized patients, and counseling patients regarding their medication regimens.
Residents contribute significantly to the continuity of patient care and engage in patient education efforts.
Side effects [ edit ]
In 2005–06, Neomycin was the fifth-most-prevalent allergen in patch test results (10.0%). [10] It is also a known GABA gamma-Aminobutyric acid antagonist and can be responsible for seizures and psychosis. [11] Like other aminoglycosides, neomycin has been shown to be ototoxic, causing tinnitus, hearing loss, and vestibular problems in a small number of patients. Neomycin affects the cochlea, which is found in the inner ear. [12] Hearing loss is caused by ear hair cell death, which occurs in response to treatment with neomycin. [13] Patients with existing tinnitus or sensorineural hearing loss are advised to speak with a healthcare practitioner about the risks and side effects prior to taking this medication. [ citation needed ]
Activity [ edit ]
Neomycin's antibacterial activity stems from its binding to the 30S subunit of the prokaryotic ribosome, where it inhibits prokaryotic translation of mRNA. [14]
Neomycin also exhibits a high binding affinity for phosphatidylinositol 4,5-bisphosphate (PIP2), a phospholipid component of cell membranes. [15]
Resistance [ edit ]
Neomycin resistance is conferred by either one of two kanamycin kinase genes. [16] Genes conferring neomycin-resistance are commonly included in DNA plasmids used to establish stable mammalian cell lines expressing cloned proteins in culture. Many commercially available protein expression plasmids contain a neo-resistance gene as a selectable marker. Currently, research is being performed to understand if derivatives of neomycin have the same antibiotic effects while still being effective against neomycin-resistant bacteria. [17]