Tobramycin Cyclosporine

Patients suffering from cystic fibrosis often use various aerosolized drugs. To reduce the viscosity of the mucus in the airways, recombinant human deoxyribonuclease is used. This enzyme is the first recombinant protein that has been developed for specific delivery to the lungs via the airways. It has a local action on the mucus in the airways and its absorption is minimal. Another drug that decreases the viscosity of the mucus is acetylcysteine. Aerosolized antibiotics are a further group of therapeutics that is widely used by cystic fibrosis patients. Solutions of antibiotics like tobramycin or colistin are used in nebulizers to prevent exacerbation of the disease. Pentamidine has been used for the prophylaxis of Pneumocystis pneumonia in patients infected with HIV virus, while chronic rejection of lung transplants provided a reason to develop an aerosol formulation of cyclosporine A. 

Avoid concurrent or sequential use of other neurotoxic and/or nephrotoxic drugs with streptomycin sulfate, including neomycin, kanamycin, gentamicin, cephaloridine, paromomycin, viomycin, polymyxin B, colistin, tobramycin, and cyclosporine. 

Kureishi A, Jewesson PJ, Rubinger M, Cole CD, Reece DE, Phillips GL, Smith JA, Chow AW. Double-blind comparison of teicoplanin versus vancomycin in febrile neutropenic patients receiving concomitant tobramycin and piperacillin effect on cyclosporin A-associated nephrotoxicity. Antimicrob Agents Chemother 1991 35(ll) 2246-52. 

Clinically important, potentially hazardous interactions with aminoglycosides, betamethasone, cyclosporine, gentamicin, halothane, inhalational anesthetics, kanamycin, magnesium salts, neomycin, quinidine, streptomycin, succinylcholine, tazobactum, tobramycin... 

Noninterfering acetaminophen, N-acetylprocainamide, amikacin, amitriptyline, clonazepam, cyclosporine, desipramine, diazepam, digoxin, disopyramide, gentamicin, p-hydrox- q>henobarbital, imipramine, Udocaine, methotrexate, netilmicm, nortriptyline, procainamide, quinidine, salicylic acid, sulfamethoxazole, tobramycin, trimethoprim, valproic add, vancomycin... 

Noninterfering acetaminophen, acyclovir, allopurinol, amoxicillin, amphotericin B, am-picillin, aspirin, azlocillin, bendrofluazide, bumetanide, buprenorphine, carbenidllin, cefazolin, cefotaxime, cefoxitin, ceftazidime, cefuroxime, cephalexin, chlorambucil, chloramphenicol, chlordiazepoxide, chlorpheniramine, chlorpropamide, cyclophosphamide, cyclosporin, C5d arabine, daunorubicin, dextropropoxyphene, dihydrocodeine, domperidone, flucytosine, furosemide, gentamicin, griseofulvin, melphalan, methotrexate, metochlo-pramide, metronidazole, miconazole, nabilone, netilmicin, nicotinamide, nitrazepam, penicillin G, piperacillin, prednisolone, procarbeizine, prochlorperazine, riboflavin, rifampin, sulfamethoxazole, thioguanine, tobramycin, tolbutamide, trimethoprim... 

Noninterfering acetaminophen, N-acetylprocainamide, amikacin, amitriptyline, amlodi-pine, carbamazepine, cefotaxime, ceftazidime, chloramphenicol, ciprofloxacin, cisapride, clindamycin, clonidine, codeine, cyclosporine, digoxin, diphenhydramine, disopyramide, ethosuximide, fluconazole, gentamicin, gentamicin, heparin, labetalol, levothyroxine, li-docaine, lithium, methotrexate, metronidazole, minoxidil, nafcillin, nifedipine, phenobar-bital, phenobarbital, phenytoin, phenytoin, primidone, procainamide, propranolol, quini-dine, ranitidine, salicylic acid, theophylline, tobramycin, tobramycin, valproic acid, warfarin... 

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