Successful renal transplantation in patients with prior history of malignancy

Successful renal transplantation in patients with prior history of malignancy

BRlEF SUMMARY OF PRESCFWNG INFORMATION CoWhod Kantrex Injection and Pedlrtrk Injectbn (kanamycin sulfate injection) For complete information, (11) 611...

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BRlEF SUMMARY OF PRESCFWNG INFORMATION CoWhod Kantrex Injection and Pedlrtrk Injectbn (kanamycin sulfate injection) For complete information, (11) 6118174

consult Otiicial Package Circular.

Warning: irreversible deafness can occur. Tinnitus or vertigo may also occur and indicate vestibular damage and impending deafness. The risk is sharply increased with renal dysfunction. In such cases, decrease size and frequency of doses. Discontinue kanamycin and check hearing if azotemia increases. Watch carefully for ototoxicity in older patients and patients receiving more than 15 Gm. of kanamycin. To avoid neuromuscular paralysis with respiratory depression, postpone intraperitoneal instillation in post-operative patients until recovery from anesthesia and muscle relaxants is complete. Al(hough there have been Isolated reports of respiratory depression following in;raperitoneal instillation of kanamycin, there is no conclusive proof that t?is side effect can be produced with recommended doses of the drug. Avoid concurrent use of other dtotoxic drugs including ethacrynic acid. Safety in pregnancy i:: not established. Indications: Serious infections due to susceptible strains of E. coli, Proteus sp., E. aerogenes, K. pneumoniae, Serratia marcescens and Mima-Herellea. Culture and sensitivity studies should be performed. Contraindications: A history of hypersensitivity to the drug. Prior auditory damage by kanamycin or other agents may be a contraindication if effective, alternative therapy is available. Precautions: Obtain audiograms before and during therapy in patients with renal dysfunctioq when treatment lasts more than 5 days. Stop Kantrex if tinnitus or hearing loss occurs. Hydrate patients to prevent chemical irritation of the renal tubules. Assess renal function periodically, both before and during therapy. If signs of renal irritation occur (casts, cells, proteinuria). increase hydration and reduce the dosage or the frequency of dosage if necessary. In azotemic patients, the frequency (in hours) of doses may be obtained by multiplying the serum creatinine by 9. If azotemia or oliguria occur, discontinue therapy. Mycotic or bacterial superinfection may occur. Adverse Reactions: Nephrotoxicity-albuminuria, presence of white and red cells, granular casts, azotemia and oliguria have been reported. Ototoxicity-See 80x Warning. Irritation or pain at the injection site, skin rash, drug fever, headache and paresthesias. Dosage and Administration: The usual dose is 7.5 mg./ Kg./12 hours I.M. or I.V. The average adult dose is 1 Gm. daily. The maximum adult total daily dose should not exceed 1.5 Gm. by all routes of administration and the total amount administered should not exceed 15 Gms. The intravenous route is used only if intramuscular administration is not feasible. The 0.5 Gm. dose is added to 200 ml. of sterile diluent and admini,stered 60-80 dnps/’ minute. When used as intraperitoneal instillation, the above dose is diluted in 20 ml. of sterile diluent. If possible, instillation should be postponed until after patient is fully recovered from effects of anesthesia and muscle-relaxing drugs. As aerosol treatment, 250 mg. of Kanlrex is diluted with 3 ml. of physiological saline and nebulize. Kantrex injection in concentrations of 0.25 percent (2.5 mg./ml.) has been used satisfactorily as an irrigating solution in abscess cavities, pleural spaces, peritoneal and ventricular cavities. Supplied: Rubber capped vials as a ready-to-use sterile aqueous solution in two concentrations: 0.5 Gm. in 2 ml., 1 .O Gm. in 3 ml. Pediatric Injection 75 mg. in 2 ml.

A50

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