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Lincomycin hydrochloride
Lincomycin hydrochloride (Lincocin)
Lincomycin hydrochloride
(link-oh-
MY-sin)
Pregnancy Category: B
Lincocin
Lincorex
(Rx)
Classification:
Anti-infective
See Also:
See also
Anti-Infectives
[.
]
Action/Kinetics:
Isolated from
Streptomyces lincolnensis. Suppresses protein synthesis by microorganisms by binding to ribosomes (50S subunit), which is essential for transmittal of genetic information. Both bacteriostatic and bactericidal. Rapidly absorbed from the GI tract and is widely distributed.
Peak serum levels: PO, 1.8-5.3 mcg/mL after 500 mg;
IM, 9.3-18.5 mcg/mL after 600 mg;
IV, 15.9-20.9 mcg/mL after 600 mg.
t
1/2: 4.4-6.4 hr. Metabolized by the liver; about 60% excreted through the urine and 40% in the feces. Do not use for trivial infections.
Uses:
Not a first-choice drug but useful for clients allergic to penicillin. Spectrum resembles that of the erythromycins. Used for serious respiratory tract, skin, and soft tissue infections due to staphylococci, streptococci, or pneumococci and some gram-negative organisms. Septicemia. In conjunction with diphtheria antitoxin in the treatment of diphtheria.
Contraindications:
Hypersensitivity to drugs. Use in pre-existing liver disease, in infants up to 1 month of age, or in treating viral and minor bacterial infections.
Special Concerns:
Safe use during pregnancy has not been established. Use with caution in clients with GI disease, liver or renal disease, or a history of allergy or asthma.
Side Effects:
GI: N&V;, diarrhea (may be severe), abdominal pain, tenesmus, flatulence, bloating, anorexia, weight loss, esophagitis, pruritus ani. Nonspecific colitis, pseudomembranous colitis (may be severe).
Allergic: Morbilliform rash (most common). Also, maculopapular rash, urticaria, pruritus, fever, hypotension. Rarely, polyarteritis,
anaphylaxis erythema multiforme.
Hematologic: Leukopenia, neutropeniaeosinophilia, thrombocytopenia,
agranulocytosis.
Miscellaneous: Superinfection.
Following IV use: Thrombophlebitis, erythema, pain, swelling. IV lincomycin may cause hypotension, syncope, and
cardiac arrest (rare).
Following IM use: Pain, induration, sterile abscesses.
Following topical use: Erythema, irritation, dryness, peeling, itching, burning, oiliness. Also, sore throat, fatigue, urinary frequency, headache.
NOTE: The injection contains benzyl alcohol, which has been associated with a fatal gasping syndrome in infants.
Laboratory Test Alterations:
 Levels of AST, ALT, NPN, alkaline phosphatase, bilirubin, BSP retention, and
platelet count.
Drug Interactions:
-
Antiperistaltic antidiarrheals (opiates, Lomotil) /
 Diarrhea due to
removal of toxins from colon
-
Erythromycin / Cross-interference
effect of both drugs
-
Kaolin (e.g., Kaopectate) /
Effect due to
absorption from GI tract
-
Neuromuscular blocking agents /
Effect of blocking agents; possible severe respiratory depression
How Supplied:
Capsule: 500 mg;
Injection: 300 mg/mL
Dosage
?Capsules
Infections.
Adults: 500 mg t.i.d. for serious infections.
Adults: 500 mg or more q 6 hr for more severe infections. Continue treatment for at least 10 days with ß-hemolytic streptococcal infections.
Children over 1 month of age: 30-60 mg/kg/day in three to four divided doses, depending on severity of infection.
?IM
Infections.
Adults: 600 mg q 24 hr for serious infections and every 12 hr or more for more severe infections.
Children over 1 month of age: 10 mg/kg q 12-24 hr, depending on severity of infection.
?IV
Infections.
Adults: 0.6-1.0 g q 8-12 hr up to 8 g/day, depending on severity of infection.
Children over 1 month of age: 10-20 mg/kg/day, depending on severity of infection.
NOTE: In impaired renal function, reduce dosage by 70%-75%.
?Subconjunctival Injection
0.75 mg/0.25 mL. |
