Paromomycin Sulfate

A to Z Drug Facts

 Action Inhibits production of protein in bacteria, causing bacterial cell death.

 Indications Treatment of acute and chronic intestinal amebiasis. Adjunctive therapy in management of hepatic coma. Unlabeled use(s): Treatment of other parasitic infections.

 Contraindications Intestinal obstruction; extraintestinal amebiasis; hypersensitivity to aminoglycosides.

 Route/Dosage

Intestinal Amebiasis

ADULTS & CHILDREN: PO 25 to 35 mg/kg/day in 3 divided doses with meals for 5 to 10 days.

Hepatic Coma

ADULTS: PO 4 g/day in divided doses at regular intervals for 5 to 6 days.

 Interactions

Digoxin: May reduce rate and extent of digoxin absorption; this may be offset by decreased digoxin metabolism. Methotrexate: Decreased absorption of methotrexate. Neuromuscular blockers: Increased action of both depolarizing and nondepolarizing neuromuscular blocking agents, may prolong need for respiratory support. Neurotoxic, nephrotoxic, or ototoxic medications (eg, polypeptide antibiotics): Additive adverse effects may occur with concurrent or sequential administration of medications with similar toxic profiles.

 Lab Test Interferences None well documented.

 Adverse Reactions

GI: Nausea; vomiting; abdominal cramps; anorexia; epigastric burning; pruritus ani; diarrhea. OTHER: Malabsorption syndrome.

 Precautions

Pregnancy: Category D. Lactation: Excreted in breast milk. Muscular disorders: Patients with muscular disorders such as myasthenia gravis or parkinsonism may have worsening of their disease because of potential effect of aminoglycosides on neuromuscular junction. Ototoxicity and renal damage: Inadvertent absorption through ulcerative bowel lesions may be associated with significant hearing and kidney damage. Superinfection: Prolonged or repeated therapy may result in bacterial or fungal overgrowth of nonsusceptible organisms and secondary infections.

 Administration/Storage

• Administer medication with meals.
• Store at room temperature in a tight container.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Assess patient for adverse reactions to paromomycin (eg, altered auditory sensory perception, GI dysfunction, nephrotoxicity, neuromuscular blockage).
• Observe for signs of superinfection.
• If nausea, vomiting or diarrhea occur, give antiemetic or antidiarrheal medication as prescribed.
• If hearing loss occurs or if audiometric testing becomes abnormal or if casts or protein appear in urinalysis, notify physician.

 Patient/Family Education

• Stress to patient the importance of taking full course of therapy.
• Emphasize to patient the importance of personal hygiene, especially handwashing.
• Explain to patient the symptoms of superinfection and ask patient to watch for symptoms if on prolonged therapy.
• Instruct patient to report the following symptoms to physician: Ringing in ears, hearing impairment, or dizziness.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts