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Nephrotoxicity following the parenteral administration of Capastat Sulfate (capreomycin for injection) is most closely related to the area under the curve of the serum concentration versus time graph. The elderly patient, patients with abnormal renal function or dehydration, and patients receiving other nephrotoxic drugs are at much greater risk for developing acute tubular necrosis.
Damage to the auditory and vestibular divisions of cranial nerve VIII has been associated with Capastat Sulfate (capreomycin for injection) given to patients with abnormal renal function or dehydration and in those receiving medications with additive auditory toxicities. These patients often experience dizziness, tinnitus, vertigo, and a loss of high-tone acuity.
Neuromuscular blockage or respiratory paralysis may occur following rapid intravenous infusion.
If capreomycin is ingested, toxicity would be unlikely because it is poorly absorbed (less than 1%) from an intact gastrointestinal system.
To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physicians' Desk Reference (PDR). In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug kinetics in your patient.
Protect the patient's airway and maintain, within acceptable limits, the patient's Absorption of drugs from the gastrointestinal tract may be decreased by giving activated charcoal, which, in many cases, is more effective than emesis or lavage; consider charcoal instead of or in addition to gastric emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Safeguard the patient's airway when employing gastric emptying or charcoal.
Patients who have received an overdose of capreomycin and have normal renal function should be carefully hydrated to maintain a urine output of 3 to 5 mL/kg/h. Fluid balance, electrolytes, and creatinine clearance should be carefully monitored.
Hemodialysis may be effectively used to remove capreomycin in patients with significant renal disease.
Capastat Sulfate (capreomycin for injection) is contraindicated in patients who are hypersensitive to capreomycin.
Last reviewed on RxList: 9/4/2008
This monograph has been modified to include the generic and brand name in many instances.
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