Carbenicillin

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Pharmacokinetics 6 Adverse-effects 7 Drug-interactions 8 Test-interactions 9 Laboratory 10 More General Terms 11 Internet Database 12 References

Introduction

• Tradename: Geocillin. 4th generation penicillin. (carbenicillin indanyl sodium)

Indications

• treatment of infections of the upper & lower urinary tracts
• asymptomatic bacteruria
• prostatitis

Contraindications

• severe renal impairment ( creatinine clearance < 10 mL/min)
  

• pregnancy category = b
• safety in lactation = ?

Dosage

• urinary tract infection: 382-764 mg PO QID for 10 days or longer
• prostatitis 764 mg QID for 2-4 weeks or longer
• children:

• 30-50 mg/kg/day divided QID
• maximum 2-3 g/day

• take with water; tablet have bitter taste

• Tabs: 382 mg. (23 mg of Na+/tab) Dose adjustment in renal failure:

*    creatinine clearance              dosage 
*      10-50 mL/min                 dose every 12-24 hours 
*       < 10 mL/min                  avoid use

Pharmacokinetics

• oral absorption: 30-40%
• distribution

• crosses placenta
• small amounts appear in breast milk
• distributes into the bile
• low concentrations in CSF

• protein binding 50%
• 1/2 life 1-1.5 hours (adults), prolonged in patients with renal insufficiency
• time to peak concentration: 0.5-2 hours
• 80-85% excreted unchanged in the urine
• serum concentrations insufficient for treatment of systemic infections
• moderately dializable (20-50%)
  

• elimination via kidney
• 1/2life = 1.1 hours
• protein binding = 50 %
• elimination by hemodialysis = +/-

Adverse-effects

• common (> 10%)

• diarrhea

• less common (1-10%)

• nausea/vomiting, taste disturbance, flatulence, glossitis

• uncommon (< 1%)

• headache, skin rash, urticaria, anemia, thrombocytopenia, leukopenia, neutropenia, eosinophilia, hyperthermia, itchy eyes, vaginitis, hypokalemia, hematuria, thrombophebitis

Drug-interactions

• give at least 1 hour prior to aminoglycosides
  
• drug interaction(s) of antibiotics with warfarin

Test-interactions

• false positive urine protein
• serum protein
• false positive urine glucose (clinitest)

Laboratory

• specimen:

• serum, plasma ( heparin, EDTA)
• stable in solution for 15 days at 5 degrees C

• methods: MB, HPLC

More General Terms

• 4th generation penicillin (extended-spectrum)

Internet Database

PubChem: 2560
PubChem: 20933
PubChem: 20824
PubChem: 2559
PubChem: 28415
PubChem: 657287
PubChem: 93184
PubChem: 33554

References

1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
3. Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995

carbenicillin; carindacillin (Geocillin)