Tobamist

Dosage : Respules for inhaler
Contains : Tobramycin
Category : Respiratory
Uses : Cystic fibrosis and Brochiectasis
Price :

Tobamist is a brand of Tobramycin respules which are manufactured by Cipla. Tobamist is prescribed in respiratory disorders like Cystic Fibrosis and Bronchiectasis. Tobamist enables assured drug delivery to the site of action.The unique formulation is known to improve therapy adherence and thereby patient compliance in the respiratory disease. Tobamist is an antibiotic which is used to relieve the infection associated with lung disorders like Cystic Fibrosis and Brochiectasis. Tobamist exerts action by binding to the bacterial RNA which stops the bacterial protein synthesis leading to bacterial death. Tobamist is administered as respules through nebulizer.

Your doctor has prescribed Tobamist as you may be suffering from Cystic Fibrosis or Bronchiectasis .Cystic fibrosis is a lung disease usually genetic in nature in which the body produces thick and sticky  mucus which blocks the lungs thereby restricting normal breathing. It is also known to be life threatening in many cases and known to reduce the life span of the affected. It is also sometimes seen in the digestive tract. The common symptoms of cystic fibrosis are as under:

 

  • Persistent cough that produces thick mucus
  • Wheezing
  • Breathlessness
  • Intolerance to exercise or activity
  • Repetitive lung infections
  • Stuffy nose

 

There are multiple diagnostic tests which are done to confirm cystic fibrosis like sputum culture,lung spirometry, immunoreactive trypsinogen etc .

 

Bronchiectasis is also a lung disorder wherein the lungs get abnormally expanded  due to collection of mucus and thus makes the them prone of infection.Respiratory infections like persistent cough, pneumonia  or whooping cough which damage the bronchi make bronchiectasis easier to contract.It is normally seen in older adults .Breathlessness and phlegm causing cough are symptoms to watch out for and get screened timely . Treatment is normally with antibiotics as prescribed by the doctor.

Dosage

As directed by your Physician

Administration

As directed by your Physician

Adverse Reactions/ Side Effects

Injection:

Ototoxicity; increased AST, ALT and serum bilirubin; decreased serum Ca, Mg, Na and K; anaemia, granulocytopenia, thrombocytopenia, leucopenia, leucocytosis and eosinophilia; fever, rash, itching, urticaria, nausea, vomiting, diarrhoea, headache, lethargy, pain on inj site, mental confusion, disorientation. Inhalation: Voice disorder, cough, pulmonary disease, reduced forced expiratory vol, sputum discolouration, rales, dyspnoea, oropharyngeal pain, haemoptysis, pharyngolaryngeal pain, fever, chest discomfort, malaise, skin rash, increased serum glucose, nausea, dysgeusia, vomiting, diarrhoea, xerostomia, increased erythrocyte sedimentation rate, increased serum Ig, myalgia, hypoacusis, deafness. Ophth oint/soln: Localized ocular toxicity and hypersensitivity (e.g. itching and oedema of the eyelid), conjunctival erythema, punctate keratitis, increased lacrimation.

 

Potentially Fatal:

Neurotoxicity and nephrotoxicity; anaphylaxis, exfoliative dermatitis, toxic epidermal necrolysis, erythema multiforme, Stevens-Johnson syndrome; neuromuscular blockade or resp paralysis.

Warnings and Precautions

Patient w/ neuromuscular disorders (e.g. myasthenia gravis, parkinsonism). Prolonged use may result in overgrowth of non-susceptible organisms. Renal impairment. Childn, premature and neonatal infants (inj). Renal impairment. Pregnancy and lactation. Patient Counselling This drug may cause temporary blurred vision, if affected, do not drive or operate machinery. Contact lens wear is not recommended during treatment (ophth). Monitoring Parameters Monitor serum Ca, Mg, and Na; renal and auditory function.

Contraindications

Hypersensitivity to tobramycin and other aminoglycosides.

Drug Interactions

Enhanced neurotoxic and nephrotoxic effects w/ other aminoglycosides (e.g. amikacin, streptomycin), cefaloridine, viomycin, polymyxin B, colistin, cisplatin and vancomycin. Enhanced toxicity w/ potent diuretics (e.g. ethacrynic acid, furosemide). Prolonged secondary apnoea may occur when given to anaesthetised patients receiving neuromuscular blocking agents (e.g. succinylcholine, tubocurarine, decamethonium). Increased risk of nephrotoxicity w/ ciclosporin and other antibacterials (e.g. cephalosporins). Antagonistic effect w/ neostigmine and pyridostigmine. May potentiate the effect of warfarin and phenindione.

Overdosage

Symptoms:

Nephrotoxicity, auditory and vestibular toxicity (e.g. dizziness, tinnitus, vertigo, loss of high-tone hearing acuity), neuromuscular blockade or resp failure.

 

Management:

Initiate resuscitative measures if resp paralysis occurs. Ca salts may be given to reverse neuromuscular blockade. Haemodialysis or peritoneal dialysis will help remove drug serum levels.

Storage

Inhalation:

Store between 2-8°C.

 

Ophthalmic:

Store between 8-27°C. Protect from light.

 

Parenteral:

Store between 20-25°C.

Mechanism of Action

Tobramycin interferes w/ bacterial protein synthesis by binding to 30S and 50S ribosomal subunits, resulting in a defective bacterial cell membrane.

References

https://www.mayoclinic.org/diseases-conditions/cystic-fibrosis/symptoms-causes/syc-20353700

https://www.nhs.uk/conditions/bronchiectasis/

https://www.mims.com/india/drug/info/tobramycin/

https://www.ndrugs.com/?s=tobamist&t=dosage

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