sisomicin

Action and Spectrum

Actions and spectrum: 

sisomicin is an antibiotic medication that belongs to the aminoglycoside class of antibiotics. It is primarily used to treat various bacterial infections. The spectrum of activity of sisomicin includes a wide range of gram-negative bacteria like Escherichia coli and Pseudomonas aeruginosa. It is often reserved for treating infections caused by bacteria. sisomicin works by inhibiting bacterial protein synthesis, leading to the death of susceptible bacteria. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Ototoxicity 

neurotoxicity 

confusion 

hallucination 

mental depression 

hypersensitivity reaction 

Nephrotoxicity 

peripheral neuropathy 

lethargy 

Convulsion 

respiratory depression 

Black Box Warning

Black Box Warning:  

sisomicin carries a black box warning due to its potential for severe side effects, including kidney and ear damage. It can cause irreversible hearing loss and kidney problems, particularly when used at high doses or for prolonged periods. Close monitoring of kidney function and hearing is crucial during sisomicin treatment. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity: sisomicin is contraindicated in individuals with a known hypersensitivity or allergic reaction to sisomicin or other aminoglycoside antibiotics. 
• Myasthenia Gravis: It is contraindicated in patients with myasthenia gravis, a neuromuscular disorder, as sisomicin can exacerbate muscle weakness. 
• Severe Renal Impairment: sisomicin is contraindicated in patients with severe renal impairment because it primarily excretes through the kidneys, and accumulation can lead to toxicity. 
• Neuromuscular Disorders: In individuals with pre-existing neuromuscular disorders other than myasthenia gravis, sisomicin should be used with caution due to the potential for neuromuscular blockade. 
• Patients with Hearing Impairment: sisomicin may exacerbate hearing impairment in patients with pre-existing auditory issues, making its use inadvisable. 

Caution: 

• Renal Impairment: sisomicin is primarily excreted by the kidneys. In patients with renal impairment, dose adjustments and close monitoring of renal function are necessary to prevent potential accumulation and nephrotoxicity. 
• Neuromuscular Disorders: sisomicin can cause neuromuscular blockade, leading to muscle weakness and potentially respiratory paralysis. Extra caution is needed in patients with neuromuscular disorders other than myasthenia gravis. 
• Monitoring: Regular monitoring of renal function, hearing, and neuromuscular function is essential during sisomicin therapy. Adjustments to the dosage or discontinuation may be necessary if signs of toxicity develop. 
• Pregnancy: sisomicin should be used during pregnancy only when the potential benefits outweigh the risks. Careful consideration and monitoring are required if it is deemed necessary. 
• Concomitant Medications: Caution is advised when sisomicin is used alongside other drugs that can cause nephrotoxicity or ototoxicity, such as certain diuretics or other aminoglycoside antibiotics.

Comorbidities: 

• Cystic Fibrosis: sisomicin is sometimes used to treat respiratory infections in individuals with cystic fibrosis. Patients with this genetic disorder may have compromised lung function and may be more prone to respiratory infections. 
• Diabetes: Diabetic patients may be more susceptible to infections, and sisomicin may be prescribed if they develop bacterial infections. 
• Immunosuppression: Individuals with conditions that weaken the immune system, such as HIV/AIDS or those undergoing organ transplantation, may be at increased risk of bacterial infections. sisomicin might be considered in these cases. 
• Myasthenia Gravis: sisomicin can be used cautiously in patients with myasthenia gravis, a neuromuscular disorder, when treating infections. However, its neuromuscular blocking properties should be carefully monitored. 
• Respiratory Conditions: Patients with chronic respiratory conditions like chronic obstructive pulmonary disease (COPD) or bronchiectasis may develop bacterial respiratory infections that require sisomicin treatment. 
• Burns and Wound Infections: Patients with burns or severe wounds are susceptible to bacterial infections, and sisomicin may be prescribed as part of their treatment. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category: not assigned 

Lactation: excreted into human milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• <b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

sisomicin is a powerful aminoglycoside antibiotic with a broad spectrum of activity against various gram-negative bacteria, including strains that have become resistant to other antibiotics. Its pharmacology is characterized by its mechanism of action and pharmacokinetic properties. 

The primary mechanism of action of sisomicin is the inhibition of bacterial protein synthesis. It accomplishes this by irreversibly binding to the 30S ribosomal subunit in bacterial cells. This binding disrupts the normal functioning of the ribosome, preventing the translation of mRNA into functional proteins. As a result, bacterial growth and reproduction are halted, leading to cell death.  

Pharmacodynamics: 

• Bacterial Protein Synthesis Inhibition: sisomicin’s primary mode of action is inhibition of bacterial protein synthesis. It achieves this by binding irreversibly to the 30S ribosomal subunit in bacterial cells. This binding interferes with the ribosome’s normal functioning, preventing the accurate reading of mRNA and the subsequent synthesis of essential bacterial proteins. 
• Concentration-Dependent Bactericidal Activity: sisomicin exhibits concentration-dependent bactericidal activity. This means that its effectiveness in killing bacteria is related to the drug’s concentration at the infection site. Higher drug concentrations result in greater bacterial killing. 
• Post-Antibiotic Effect (PAE): Aminoglycosides like sisomicin often have a post-antibiotic effect, meaning that bacterial growth is suppressed even after the drug has been eliminated from the body. This effect contributes to the drug’s efficacy in treating infections. 
• Dose-Response Relationship: There is a dose-response relationship with sisomicin, where increasing the dose can lead to increased bacterial killing. However, this must be balanced with the risk of toxicity, particularly nephrotoxicity (kidney damage) and ototoxicity (ear damage), which can be associated with higher doses.

Pharmacokinetics: 

Absorption 

sisomicin is not absorbed orally and is administered through parenteral routes, such as intramuscular or intravenous injection. This means that it is typically not taken by mouth but is directly introduced into the bloodstream. 

Distribution 

sisomicin has a limited distribution within the body. It primarily remains in the extracellular fluid, including plasma and interstitial fluid. It does not penetrate well into certain body tissues, such as the central nervous system (CNS), due to its hydrophilic nature. 

Metabolism 

sisomicin is not significantly metabolized in the body. It retains its chemical structure as it exerts its antibacterial activity. This is a characteristic shared by many aminoglycoside antibiotics. 

Elimination and excretion 

The elimination of sisomicin occurs primarily through the kidneys. The drug is filtered by the renal glomeruli, and a portion of administered dose is excreted unchanged in the urine. The elimination half-life of sisomicin can vary among individuals but is short. 

Adminstartion

Administration: 

• Intramuscular (IM) Injection: sisomicin can be administered as an intramuscular injection into a large muscle, such as the thigh or buttock. This route allows for the gradual absorption of the drug into the bloodstream. 
• Intravenous (IV) Injection: Intravenous administration involves delivering sisomicin directly into a vein. This method ensures rapid and complete absorption of the drug, making it suitable for serious infections or when a quick therapeutic response is needed. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: sisomicin 

Pronounced: (sigh-soh-my-sin)  

Why do we use sisomicin? 

• Treatment of Infections: sisomicin is effective against a variety of bacterial infections caused by Gram-negative bacteria. It is used to treat the respiratory tract infections, bone and joint infections, skin & soft tissue infections, urinary tract infections, and septicemia. 
• Hospital-Acquired Infections: sisomicin is sometimes used in hospital settings to treat infections that are acquired during a hospital stay. It can be administered intravenously for serious infections. 
• Burn Infections: In some cases, sisomicin may be used to prevent or treat infections in individuals with severe burns.