A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Tobradex Pharmacology, Pharmacokinetics, Studies, Metabolism - Tobramycin and Dexamethasone
Tobradex Pharmacology, Pharmacokinetics, Studies, Metabolism - Tobramycin and Dexamethasone
CLINICAL PHARMACOLOGY
Corticoids suppress the inflammatory response
to a variety of agents and they probably delay or
healing. Since corticoids may inhibit the body's defense
mechanism against
infection, a concomitant
antimicrobial drug may be used when this inhibition
is considered to be clinically significant. Dexamethasone is a potent
corticoid.
The antibiotic component
in the combination (tobramycin) is included to provide action
against susceptible
organisms. In vitro studies have demonstrated that tobramycin
is active against susceptible
strains of the following microorganisms:
Staphylococci, including S. aureus and S. epidermis
(coagulase-positive and coagulase-negative), including penicillin-resistant
strains.
Streptococci, including some of the Group A-beta-hemolytic species,
some nonhemolytic species, and some Streptococcus
pneumoniae.
Pseudomonas aeruginosa, Escherichia
Coli, Klebsiella
pneumoniae, Enterobacter aerogenes, Proteus
mirabilis, Morganella morganii most Proteus
vulgaris strains, Haemophilus
influenzae and H. aegyptius, Moraxella lacunata. Acinetobacter calcoaceticus
and some Neisseria
species.
Bacterial susceptibility studies demonstrate that in some cases
microorganisms resistant to gentamicin
remain susceptible
to tobramycin.
No data are available on the extent of systemic
absorption from dexamethasone
and tobramycin ophthalmic
suspension or ointment;
however, it is known that some systemic
absorption can occur
with ocularly applied drugs. If the maximum
dose of dexamethasone
and tobramycin suspension
or ointment is given for the first 48 hours (two drops
in each eye every 2 hours)
and complete systemic
absorption occurs,
which is highly unlikely, the daily dose of dexamethasone
would be 2.4 mg. The usual physiologic replacement dose id
0.75 mg daily. If dexamethasone
and tobramycin ophthalmic
suspension is given after the first 48 hours as two drops
in each eye every 4 hours,
the administered dose of
dexamethasone
would be 1.2 mg daily.
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