跳转到内容

阿米卡星:修订间差异

维基百科,自由的百科全书
删除的内容 添加的内容
Cuaxdon留言 | 贡献
应用:​ 修飾語句
InternetArchiveBot留言 | 贡献
Add 1 book for verifiability (20240917sim)) #IABot (v2.0.9.5) (GreenC bot
 
(未显示5个用户的24个中间版本)
第1行: 第1行:
{{Infobox drug
{{medical}}
| Watchedfields = changed
{{drugbox
| verifiedrevid = 464364466
| IUPAC_name = O-3氨基-3-脱氧-a-D-蒲吡喃糖基-(1-6)-O-[6-氨基-6-脱氧-a-D-蒲吡喃糖基-(1-4)]-N-(4-氨基-2-羟基-1-氧丁基)-2-脱氧-D-链霉胺硫
| image = Amikacin.svg
| image = Amikacin.svg
| width =
| CAS_number_Ref = {{cascite|correct|??}}
| alt =
| CAS_number = 37517-28-5
| image2 = Amikacin 3D ball-and-stick 4P20.png
| width2 =
| alt2 =
| caption =

<!-- Clinical data -->
| pronounce =
| tradename = Amikin、Amiglyde-V、Arikayce及其他
| Drugs.com = {{drugs.com|monograph|amikacin-sulfate}}
| MedlinePlus = a682661
| DailyMedID = Amikacin
| pregnancy_AU = D
| pregnancy_AU_comment = <ref name="Drugs.com pregnancy">{{cite web | title=Amikacin Use During Pregnancy | website=Drugs.com | date=2019-12-02 | url=https://www.drugs.com/pregnancy/amikacin.html | access-date=2020-03-13 | archive-date=2020-07-25 | archive-url=https://web.archive.org/web/20200725052838/https://www.drugs.com/pregnancy/amikacin.html | dead-url=no }}</ref>
| pregnancy_category=
| routes_of_administration = [[肌肉注射]]、[[靜脈注射]]及口部吸入
| class = [[氨基糖苷類抗生素|胺基糖苷類抗生素]]
| ATCvet =
| ATC_prefix = D06
| ATC_prefix = D06
| ATC_suffix = AX12
| ATC_suffix = AX12
| ATC_supplemental = {{ATC|J01|GB06}} {{ATC|S01|AA21}}
| ATC_supplemental = {{ATC|J01|GB06}}, {{ATC|S01|AA21}}, {{ATC|J01|RA06}}, {{ATCvet|D06|AX12}}, {{ATCvet|J01|GB06}}, {{ATCvet|S01|AA21}}, {{ATCvet|J01|RA06}}

| PubChem = 441188
<!-- Legal status -->
| PubChem2 = 37768
| legal_AU = S4
| DrugBank_Ref = {{drugbankcite|changed|??}}
| legal_AU_comment = <ref>{{cite web | title=Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017 | website=Therapeutic Goods Administration (TGA) | date=21 June 2022 | url=https://www.tga.gov.au/resources/publication/publications/prescription-medicines-registration-new-generic-medicines-and-biosimilar-medicines-2017 | access-date=2024-03-30 | archive-date=2023-07-06 | archive-url=https://web.archive.org/web/20230706023149/https://www.tga.gov.au/resources/publication/publications/prescription-medicines-registration-new-generic-medicines-and-biosimilar-medicines-2017 | dead-url=no }}</ref>
| DrugBank = APRD00550
| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F-->
| DrugBank2_Ref = {{drugbankcite|correct|drugbank}}
| legal_BR_comment =
| DrugBank2 = DB00479
| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_CA_comment =
| legal_DE = <!-- Anlage I, II, III or Unscheduled-->
| legal_DE_comment =
| legal_NZ = <!-- Class A, B, C -->
| legal_NZ_comment =
| legal_UK = POM
| legal_UK_comment = <ref>{{cite web | title=Amikacin 250 mg/ml Injection - Summary of Product Characteristics (SmPC) | website=(emc) | date=16 September 2015 | url=https://www.medicines.org.uk/emc/medicine/619 | access-date=2020-03-13 | archive-date=2020-03-13 | archive-url=https://web.archive.org/web/20200313193548/https://www.medicines.org.uk/emc/medicine/619 | dead-url=no }}</ref>
| legal_US = Rx-only
| legal_US_comment = <ref name="Arikayce FDA label" />
| legal_EU = Rx-only
| legal_EU_comment = <ref name="Arikayce liposomal EPAR">{{cite web | title=Arikayce liposomal EPAR | website=European Medicines Agency | date=21 July 2020 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/arikayce-liposomal | access-date=2023-03-04 | archive-date=2023-09-24 | archive-url=https://web.archive.org/web/20230924020219/https://www.ema.europa.eu/en/medicines/human/EPAR/arikayce-liposomal | dead-url=no }}</ref><ref>{{cite web | title=Arikayce liposomal Product information | website=Union Register of medicinal products | url=https://ec.europa.eu/health/documents/community-register/html/h1469.htm | access-date=2023-03-03 | archive-date=2023-03-05 | archive-url=https://web.archive.org/web/20230305062002/https://ec.europa.eu/health/documents/community-register/html/h1469.htm | dead-url=no }}</ref>
| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV-->
| legal_UN_comment =
| legal_status = <!--For countries not listed above-->

<!-- Pharmacokinetic data -->
| bioavailability = >90%<ref name="plumb"/>
| protein_bound = 0–11%
| metabolism = 幾乎不會被代謝
| metabolites =
| onset =
| elimination_half-life = 2–3小時
| duration_of_action =
| excretion = [[腎]]臟

<!-- Identifiers -->
| index2_label = as salt
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 37517-28-5
| CAS_supplemental =
| PubChem = 37768
| IUPHAR_ligand =
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB00479
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 34635
| ChemSpiderID = 34635
第20行: 第72行:
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D02543
| KEGG = D02543
| KEGG2_Ref = {{keggcite|correct|kegg}}
| KEGG2 = D00865
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI = 2637
| ChEBI = 2637
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 177
| ChEMBL = 177
| NIAID_ChemDB =
| C = 22 | H = 43 | N = 5 | O = 13
| PDB_ligand =
| molecular_weight = 585.603 g/mol
| synonyms =
| bioavailability = >90%<ref name="plumb">{{cite book | last=Plumb | first=Donald C. | title=Plumb's Veterinary Drug Handbook | chapter=Amikacin Sulfate | location=Stockholm, Wisconsin; Ames, Iowa | date=2011 | edition=7th | publisher=Wiley | isbn=978-0-470-95964-0 | pages=39–43}}</ref>

| protein_bound = 0-11%
<!-- Chemical and physical data -->
| metabolism =
| IUPAC_name = (2''S'')-4-Amino-''N''-[(2''S'',3''S'',4''R'',5''S'')-5-amino-2-[(2''S'',3''R'',4''S'',5''S'',6''R'')-4-amino-3,5-dihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-4-[(2''R'',3''R'',4''S'',5''R'',6''R'')-6-(aminomethyl)-3,4,5-trihydroxy-oxan-2-yl]oxy-3-hydroxy-cyclohexyl]-2-hydroxybutanamide
| elimination_half-life = 2-3 hours
| C=22 | H=43 | N=5 | O=13
| excretion = 肾
| SMILES = O=C(N[C@H]3[C@H](O[C@H]1O[C@@H]([C@@H](O)[C@H](N)[C@H]1O)CO)[C@@H](O)[C@H](O[C@H]2O[C@H](CN)[C@@H](O)[C@H](O)[C@H]2O)[C@@H](N)C3)[C@@H](O)CCN
| pregnancy_AU = D
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| pregnancy_US = C
| StdInChI = 1S/C22H43N5O13/c23-2-1-8(29)20(36)27-7-3-6(25)18(39-22-16(34)15(33)13(31)9(4-24)37-22)17(35)19(7)40-21-14(32)11(26)12(30)10(5-28)38-21/h6-19,21-22,28-35H,1-5,23-26H2,(H,27,36)/t6-,7+,8-,9+,10+,11-,12+,13+,14+,15-,16+,17-,18+,19-,21+,22+/m0/s1
| legal_UK = POM
| StdInChI_comment =
| legal_US = Rx-only
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| routes_of_administration = [[肌肉注射]]、[[静脉注射]]
| StdInChIKey = LKCWBDHBTVXHDL-RMDFUYIESA-N
| density =
| density_notes =
| melting_point =
| melting_high =
| melting_notes =
| boiling_point =
| boiling_notes =
| solubility =
| sol_units =
| specific_rotation =
}}
}}


'''阿米卡星'''({{lang-en|Amikacin}})是一種[[抗生素]]藥物,用於治療多種[[病原細菌]][[感染]],<ref name=AHFS2016>{{cite web|url=https://www.drugs.com/monograph/amikacin-sulfate.html|title=Amikacin Sulfate|publisher=The American Society of Health-System Pharmacists|access-date=2016-12-08|url-status=live|archive-url=https://web.archive.org/web/20161220231044/https://www.drugs.com/monograph/amikacin-sulfate.html|archive-date= 2016-12-20}}</ref>包括[[敗血性關節炎]]、{{le|腹腔內感染|intra-abdominal infection}}、[[腦膜炎]]、[[肺炎]]、[[敗血症]]和[[泌尿道感染]]。<ref name=AHFS2016/>它也用於治療{{le|多重抗藥性結核病|Multidrug-resistant tuberculosis}}。<ref name=WHO2008>{{cite book | title = WHO Model Formulary 2008 | url = https://archive.org/details/whomodelformular00unse | year = 2009 | isbn = 9789241547659 | vauthors = ((World Health Organization)) | veditors = Stuart MC, Kouimtzi M, Hill SR | hdl = 10665/44053 | author-link = World Health Organization | publisher = World Health Organization | hdl-access=free |page=[https://archive.org/details/whomodelformular00unse/page/137 137]}}</ref>此藥物經由[[靜脈注射]]、[[肌肉注射]]及口部吸入方式使用。<ref name=AHFS2016/>
'''阿米卡星'''(amikacin)是一种[[氨基糖苷类抗生素]],用于治疗多种[[细菌感染]]。阿米卡星依靠于细菌[[30S亚基]]结合,阻断细菌[[蛋白质合成]]而起到抗菌作用。

阿米卡星與其他[[氨基糖苷类抗生素|胺基糖苷類藥物]]一樣,會導致聽力損失、身體平衡問題和[[腎功能衰竭]]。<ref name=AHFS2016/>其他的副作用有[[癱瘓]](導致無法呼吸)。<ref name=AHFS2016/>如果個體在[[姙娠|懷孕]]期間使用,出生的後代可能會永久性失聰。<ref name=AHFS2016/><ref name="Drugs.com pregnancy" />阿米卡星是透過阻斷細菌[[30S核糖體亞基]]的功能,使其無法產生蛋白質而發揮作用。<ref name=AHFS2016/>

==醫療用途==
阿米卡星最常用於治療嚴重性多重抗藥性與需氧[[革蘭氏陰性菌]]的感染,後者細菌特別指[[假單胞菌屬]]、[[不動桿菌屬]]、[[腸桿菌屬]]、[[大腸桿菌]]、[[變形桿菌屬]]、[[克雷伯氏菌屬]]和[[沙雷氏菌屬]]。<ref name="Amikacin sulfate FDA label">{{cite web | title=Amikacin sulfate injection, solution | website=DailyMed | date=2019-4-10 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c0f57839-1c9b-49e5-8c7a-708e2d16495d | access-date=2020-05-13 | archive-date=2020-03-13 | archive-url=https://web.archive.org/web/20200313193145/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c0f57839-1c9b-49e5-8c7a-708e2d16495d | dead-url=no }}</ref>少數會受阿米卡星強烈影響的[[革蘭氏陽性菌]]有[[葡萄球菌屬]]<ref name="Amikacin sulfate FDA label" />及[[諾卡氏菌屬]]兩種。 <ref>{{cite book | vauthors = Scholar EM, Pratt WB | title=The Antimicrobial Drugs | date=2000-05-22 | pages=15–19 | url=https://books.google.com/books?id=gACeB8XCnpgC&pg=PA15 | edition=2nd | publisher=Oxford University Press, USA | isbn=978-0-19-975971-2 | url-status=live | archive-url=https://web.archive.org/web/20170910172330/https://books.google.com/books?id=gACeB8XCnpgC&pg=PA15 | archive-date=2017-09-10 }}</ref>在第一線藥物無法控制非結核[[分枝桿菌屬]]感染和[[結核病]]感染(且如果是對阿米卡星效力敏感的菌株所引起)時,也可使用阿米卡星治療。<ref name=AHFS2016 />此種藥物在治療時很少會單獨使用。<ref name=cunha>{{cite journal | vauthors = Cunha BA | title = New uses for older antibiotics: nitrofurantoin, amikacin, colistin, polymyxin B, doxycycline, and minocycline revisited | url = https://archive.org/details/sim_medical-clinics-of-north-america_2006-11_90_6/page/1089 | journal = The Medical Clinics of North America | volume = 90 | issue = 6 | pages = 1089–1107 | date = November 2006 | pmid = 17116438 | doi = 10.1016/j.mcna.2006.07.006 | series = Antimicrobial Therapy | s2cid = 30373734 }}</ref>

阿米卡星常用於治療下述疾病:<ref name=AHFS2016 />

*[[支氣管擴張]]<ref name=medscape>{{cite web | work=Medscape | title=amikacin (Rx) | publisher=WebMD | access-date=2017-08-09 | url=http://reference.medscape.com/drug/amikin-amikacin-342516#0 | url-status=live | archive-url=https://web.archive.org/web/20170809083119/http://reference.medscape.com/drug/amikin-amikacin-342516 | archive-date=2017-08-09 }}</ref>
*骨骼和關節感染
*與[[替卡西林]]共同使用,治療[[癌症]]患者的[[粒細胞]]減少症<ref name="aronson">{{cite book |editor=Aronson J. K.| title=Meyler's Side Effects of Drugs | chapter=Amikacin | location=Oxford | date=2016 | edition=16th | publisher=Elsevier | isbn=978-0-444-53716-4 | pages=207–209}}</ref>
*作為其他藥物(如[[克林黴素]]、[[甲硝唑]]、{{le|哌拉西林/他唑巴坦|piperacillin/tazobactam}}或{{le|氨芐西林/舒巴坦|ampicillin/sulbactam}})的輔助藥物,用於治療腹腔內感染(如[[腹膜炎]])
*腦膜炎
*分枝桿菌屬感染,包括用作治療活動性結核病的二線藥物。<ref>{{cite book | vauthors = Vardanyan R, Hruby V | title=Synthesis of Best-Seller Drugs | chapter=Chapter 32: Antimicobacterial Drugs | location=Boston| date=2016| publisher=Academic Press | isbn=978-0-12-411492-0 | pages=669–675}}</ref>它也用於治療由{{le|鳥分枝菌群|Mycobacterium avium complex}}、{{le|膿腫分枝桿菌|Mycobacteroides abscessus}}、{{le|龜分枝菌群|Mycobacteroides chelonae}}和{{le|偶發分枝菌群|Mycobacterium fortuitum}}的感染。
*{{le|玫瑰紅球菌|Rhodococcus equi }}所引起類似結核病的感染
*呼吸道感染,包括作為[[β-內醯胺]]類或[[碳青黴烯]]類藥物的輔助藥物,用以治療{{le|院內型肺炎|hospital-acquired pneumonia}}
*敗血症,包括新生兒敗血症,<ref name="Amikacin sulfate FDA label" />作為β-內酰胺類或碳青黴烯類藥物的輔助藥物
*皮膚和手術縫合部位感染<ref name="Amikacin sulfate FDA label" />
*對毒性較低藥物具有抗藥性的細菌所引起的泌尿道感染(通常是[[腸桿菌科]]細菌或[[綠膿桿菌]])

阿米卡星可與β-內酰胺類抗生素聯合針對[[嗜中性白血球低下]]和[[發燒]]患者進行{{le|經驗治療|empiric therapy}}。<ref name=AHFS2016 />

===懸浮液吸入劑===
[[美國]]<ref name="FDA PR">{{cite press release |title=FDA approves a new antibacterial drug to treat a serious lung disease using a novel pathway to spur innovation |url=https://www.fda.gov/news-events/press-announcements/fda-approves-new-antibacterial-drug-treat-serious-lung-disease-using-novel-pathway-spur-innovation |website=U.S. [[Food and Drug Administration]] (FDA) |access-date=2018-11-12 |archive-date=2019-10-01 |archive-url=https://web.archive.org/web/20191001182321/https://www.fda.gov/news-events/press-announcements/fda-approves-new-antibacterial-drug-treat-serious-lung-disease-using-novel-pathway-spur-innovation |dead-url=no }} {{PD-notice}}</ref><ref name="Arikayce FDA label">{{cite web | title=Arikayce- amikacin suspension | website=DailyMed | date=2018-09-30 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=499ab990-2b21-474f-aaba-d86388965f40 | access-date=2020-03-13 | archive-date=2020-03-13 | archive-url=https://web.archive.org/web/20200313194403/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=499ab990-2b21-474f-aaba-d86388965f40 | dead-url=no }}</ref>和[[歐盟]]<ref name="Arikayce liposomal EPAR" />也批准使用含阿米卡星的[[脂質體]]懸浮液吸入劑,用於治療鳥分枝菌群感染。

===特定人口群組===
對於老年人和兒童,由於老年人通常會出現隨年齡增長而有的腎功能下降,而兒童則為腎臟尚未發育完全,而應採小劑量治療方式。此藥物在美國和[[澳大利亞]]被歸類為妊娠類別D,表示有可能會傷害胎兒。<ref name="FDA PR" />

阿米卡星於人體內的分布容積、清除率以及對特殊人群的影響如下述:

*一般來說,應避免將阿米卡星用於嬰兒身上。<ref name=ettinger>{{cite book | vauthors = Ettinger SJ, Feldman EC | title=Textbook of Veterinary Internal Medicine | date=2009-12-24 | pages=1976, 523 | url=https://books.google.com/books?id=4Qzau1jagOYC&pg=PA1976 | publisher=Elsevier Health Sciences | isbn=978-1-4377-0282-8 | url-status=live | archive-url=https://web.archive.org/web/20170910172330/https://books.google.com/books?id=4Qzau1jagOYC&pg=PA1976 | archive-date=2017-09-10 }}</ref>嬰兒由於細胞外液濃度較高,其藥物分布容積也往往更大,會含有更多胺基糖苷類藥物。<ref name="plumb" >{{cite book | vauthors = Plumb DC | title=Plumb's Veterinary Drug Handbook | url = https://archive.org/details/plumbsveterinary0000plum_o2u8 | chapter=Amikacin Sulfate | location=Stockholm, Wisconsin; Ames, Iowa | date=2011 | edition=7th | publisher=Wiley | isbn=978-0-470-95964-0 | pages=[https://archive.org/details/plumbsveterinary0000plum_o2u8/page/39 39]–43}}</ref>
*阿米卡星於老年人體內的停留時間往往更長。 20歲患者的阿米卡星平均清除率為每小時6升,而80歲患者則為每小時3升。<ref name=maire>{{cite book | vauthors = Maire P, Bourguignon L, Goutelle S, Ducher M, Jelliffe R | chapter=Chapter 20 – Individualizing Drug Therapy in the Elderly | veditors = Jelliffe RW, Neely M | title=Individualized Drug Therapy for Patients | location=Boston | date=2017 | publisher=Academic Press | isbn=978-0-12-803348-7 | pages=373–382}}</ref>
*[[囊腫性纖維化]]患者的清除率則更高。<ref name="eghianruwa">{{cite book | vauthors = Eghianruwa K | title=Essential Drug Data for Rational Therapy in Veterinary Practice | date=2014 | page=16 | url=https://books.google.com/books?id=h4zCAgAAQBAJ&pg=PA16 | publisher=Author House | isbn=978-1-4918-0000-3 | url-status=live | archive-url=https://web.archive.org/web/20170910172330/https://books.google.com/books?id=h4zCAgAAQBAJ&pg=PA16 | archive-date= 2017-09-10 }}</ref>
*對於患有肌肉疾患,如[[重症肌無力症]]或[[帕金森氏症]]等的患者,阿米卡星的神經肌肉銜接阻滯作用可能會加劇肌肉無力症状。<ref name=AHFS2016/>

==不良影響==
阿米卡星的副作用與其他胺基糖苷類藥物相似。{{le|腎毒性|Nephrotoxicity}}和{{le|耳毒性|ototoxicity }}(可導致聽力損失)是最重要的影響,會發生在1-10%的使用者身上。<ref name=medscape />腎毒性和耳毒性被認為是由於胺基糖苷類藥物容易在腎臟和[[內耳]]中累積所致。<ref name=plumb />
[[File:Gray920.png|thumb|人類內耳圖,阿卡米星會對[[耳蝸]]及[[耳前庭]]造成損害。|300x300px]]

如果使用較高劑量或使用時間超過建議時,可能會導致神經毒性。

含阿米卡星脂質體懸浮液吸入劑的處方資訊中列有[[黑框警告]],指出使用將涉及有關呼吸系統疾病風險增加,包括過敏性肺炎、支氣管痙攣、潛在肺部疾病惡化和[[咳血]],且在某些情況下需住院治療。<ref name="FDA PR" /><ref name="Arikayce FDA label" />使用此類吸入劑的患者的其他常見副作用有[[聲音嘶啞]]、[[咳嗽]]、耳毒性、上呼吸道不適、肌肉骨骼疼痛、疲勞、[[腹瀉]]和[[噁心]]。<ref name="FDA PR" /><ref name="Arikayce FDA label" />

==禁忌症==
對任何胺基糖苷類藥物敏感的患者應避免使用,因為阿米卡星會引發交叉過敏性。對[[亞硫酸鹽]]敏感的人也應避免使用(在氣喘患者中更為常見),<ref name="Amikacin sulfate FDA label" />因為大多數阿米卡星通常含有[[焦亞硫酸鈉]],可能會引起過敏反應。<ref name=AHFS2016 />

一般來說,阿米卡星不應與另一種可引起神經毒性、耳毒性或腎毒性的藥物一起使用,或在其之前/之後使用。此類藥物包括其他胺基糖苷類藥物、[[阿昔洛韋]](抗病毒)、[[兩性黴素B]](抗真菌)、[[桿菌肽]](抗生素)、{{le|捲曲黴素|capreomycin}}、[[粘菌素]]、[[多粘菌素B]]和[[萬古黴素]],以及用於[[化學療法]]的[[順鉑]]。<ref name=AHFS2016 />

阿米卡星不應與[[神經肌肉阻滯藥]]一起使用,因為它們會加劇肌肉無力和癱瘓。<ref name=AHFS2016 />

==藥物交互作用==
阿米卡星可被其他β-內酰胺類藥物滅活,但程度不如其他胺基糖苷類藥物,而仍經常與[[青黴素]](一種β-內酰胺類藥物)和碳青黴烯類藥物一起使用,以產生針對某些細菌的附加作用。已知抗生素[[氯黴素]]、克林黴素和[[四環黴素]]通常透過藥理拮抗作用讓胺基糖苷類藥物失去活性。<ref name=AHFS2016 />

阿米卡星的藥理拮抗劑作用會降低某些[[疫苗]]的效果,例如活的減毒[[卡介苗]](用於預防結核病)、[[霍亂疫苗]]和口服減活[[傷寒疫苗]]。<ref name=medscape />

==藥理學==
===作用機制===
[[File:010 small subunit-1FKA.gif|thumb|原核生物30S核糖體亞基。圖中,橙色部分代表16S 核糖體RNA,藍色部分代表附着的各種蛋白質。]]

阿米卡星不可逆地與[[16S 核糖體RNA]]和30S核糖體亞基的RNA結合S12蛋白結合,並透過改變[[核醣體]]的形狀來抑制蛋白質合成,使其無法正確讀取[[信使核糖核酸]]的[[遺傳密碼]]。<ref name="Amikacin sulfate FDA label" /><ref name="bauman">{{cite book | vauthors = Bauman RW | title=Microbiology: with diseases by body system | url = https://archive.org/details/microbiologywith0000baum_q4z6 | location=Boston | date=2015 | edition=4th | publisher=Pearson | isbn=978-0-321-91855-0}}</ref>它也干擾與[[轉運核糖核酸]](tRNA)反遺傳密碼[[搖擺鹼基對]]相互作用的區域。<ref name="drugbank">{{cite web|url=https://www.drugbank.ca/drugs/DB00479|title=Amikacin|date=2017-08-02|work=DrugBank|access-date=2017-08-10|url-status=live|archive-url=https://web.archive.org/web/20170816150102/https://www.drugbank.ca/drugs/DB00479|archive-date=2017-08-16}}</ref>其作用有濃度依賴性,在鹼性環境下作用較佳。<ref name="plumb" />

在正常劑量下,會在24-48小時內對具有阿米卡星敏感性的細菌發生作用。<ref name="Amikacin sulfate FDA label" />

===抗藥性===
阿米卡星可避開所有抗生素失活酶的攻擊,而這些酶會導致細菌對抗生素產生抗藥性,但氨基乙醯轉移酶和核苷酸轉移酶兩者除外。<ref name=mudd>{{cite web | vauthors = Mudd E | title=O Aminoglycosides | work=Pharmacological Sciences | access-date= 2017-08-14 | date= 2017-08-07 | url=https://www.pharmacologicalsciences.us/pharmaceutical-chemistry/o-aminoglycosides.html | url-status=live | archive-url=https://web.archive.org/web/20170816105922/https://www.pharmacologicalsciences.us/pharmaceutical-chemistry/o-aminoglycosides.html | archive-date= 2017-08-16 }}</ref>

===藥物動力學===
阿米卡星無法經由口服方式吸收,因此必須經由腸胃外給藥。於肌肉注射時,它在0.5-2小時內達到血清濃度的峰值。不到11%的阿米卡星會與血漿蛋白結合,分佈在[[心臟]]、[[膽囊]]、肺和[[骨骼]]中,以及[[膽汁]]、[[痰]]、組織液、胸膜液和[[滑液]]之中。

==化學==
阿米卡星由卡那黴素衍生而來。<ref name=kawaguchi>{{cite journal | vauthors = Kawaguchi H, Naito T, Nakagawa S, Fujisawa KI | title = BB-K 8, a new semisynthetic aminoglycoside antibiotic | journal = The Journal of Antibiotics | volume = 25 | issue = 12 | pages = 695–708 | date = December 1972 | pmid = 4568692 | doi = 10.7164/antibiotics.25.695 | url = https://www.jstage.jst.go.jp/article/antibiotics1968/25/12/25_12_695/_pdf | url-status = live | doi-access = free | archive-url = https://web.archive.org/web/20170816105728/https://www.jstage.jst.go.jp/article/antibiotics1968/25/12/25_12_695/_pdf | archive-date = 2017-08-16 }}</ref><ref name=monteleone>{{cite book | vauthors = Monteleone PM, Muhammad N, Brown RD, McGrory JP, Hanna SA | title=Amikacin Sulfate | date=1983-01-01| doi=10.1016/S0099-5428(08)60163-X | issn=0099-5428 | volume=12 | pages=37–71| series=Analytical Profiles of Drug Substances | publisher=Academic Press | isbn=9780122608124 }}</ref>
[[File:Amikacin synthesis 2.svg|center|阿米卡星由卡那黴素衍生而來的過程|800x800px]]


==给药途径==
==社會與文化==
阿米卡星於1971年由[[禮來]]公司提出申請,於1972年獲得專利,並於1976年進入商業販售。<ref>{{cite book| vauthors = Fischer J, Ganellin CR |title=Analogue-based Drug Discovery|date=2006|publisher=John Wiley & Sons|isbn=9783527607495|page=507|url=https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA507|url-status=live|archive-url=https://web.archive.org/web/20161220092307/https://books.google.ca/books?id=FjKfqkaKkAAC&pg=PA507|archive-date=2016-12-20}}</ref><ref>{{cite book|title=Oxford Handbook of Infectious Diseases and Microbiology|date=2009|publisher=OUP Oxford|isbn=9780191039621|page=56|url=https://books.google.com/books?id=5W-WBQAAQBAJ&pg=PT56|url-status=live|archive-url=https://web.archive.org/web/20151124232554/https://books.google.ca/books?id=5W-WBQAAQBAJ&pg=PT56|archive-date=2015-11-24}}</ref>它已被列入[[世界衛生組織基本藥物標準清單]]之中。<ref name="WHO21st">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref>
阿米卡星一天可以给药一次或两次,但必须通过不方便的静脉注射或肌肉注射给药。阿米卡星不能口服。肾衰竭患者剂量应该按情况调整。


==用==
==獸醫==
雖然阿米卡星獲得[[美國食品藥物管理局]](FDA)批准,僅適用於治療狗和馬的子宮內感染,但它是[[獸醫學]]中最常使用的氨基糖苷類藥物之一,<ref name=forney>{{cite web | vauthors = Forney B | title=Amikacin for Veterinary Use | work=Wedgewood Pharmacy | access-date=2017-08-09 | url=http://www.wedgewoodpetrx.com/learning-center/professional-monographs/amikacin-for-veterinary-use.html | url-status=live | archive-url=https://web.archive.org/web/20170816110344/http://www.wedgewoodpetrx.com/learning-center/professional-monographs/amikacin-for-veterinary-use.html | archive-date=2017-08-16 }}</ref>並已用於狗、貓、[[豚鼠]]、[[絨鼠]]、[[倉鼠]]、{{le|小鼠|mouse}}、[[土撥鼠]]、[[家牛]]、[[鳥]]、[[蛇]]、[[龜鱉目|烏龜]]和[[陸龜]]、[[鱷魚]]、[[牛蛙]]和[[魚]]的治療。<ref name=plumb /><ref>{{cite book | vauthors = Riviere JE, Papich MG | title=Veterinary Pharmacology and Therapeutics | date=2013-05-13 | page=931 | url=https://books.google.com/books?id=xAPa4WDzAnQC&pg=PA931 | publisher=John Wiley & Sons | isbn=978-1-118-68590-7 | url-status=live | archive-url=https://web.archive.org/web/20170910172330/https://books.google.com/books?id=xAPa4WDzAnQC&pg=PA931 | archive-date=2017-09-10 }}</ref><ref>{{cite book | vauthors = Mader DR, Divers SJ | title=Current Therapy in Reptile Medicine and Surgery – E-Book | date=2013-12-12 | page=382 | url=https://books.google.com/books?id=2phWAgAAQBAJ&pg=PA382 | publisher=Elsevier Health Sciences | isbn=978-0-323-24293-6 | url-status=live | archive-url=https://web.archive.org/web/20170910172330/https://books.google.com/books?id=2phWAgAAQBAJ&pg=PA382 | archive-date=2017-09-10 }}</ref>它常用於治療蛇的呼吸道感染、烏龜的細菌性甲殼病和[[金剛鸚鵡]]的[[鼻竇炎]]。它通常禁用於家[[兔]]和野兔(但仍被使用),因為它會損害兔類[[腸道菌群]]的平衡。<ref name=plumb />
阿米卡星常用于治疗严重的多药物耐药的[[革兰氏阴性菌]]医院获得性感染,如[[绿脓杆菌]]、[[不动杆菌]]和肠杆菌等。
治疗[[中性粒细胞]]缺乏伴发热的患者时,阿米卡星常与[[Β-内酰胺类抗生素|β-内酰胺类药物]]连用。


對於狗和貓,阿米卡星通常用作外用抗生素,治療[[耳炎]]和角膜潰瘍,尤其是綠膿桿菌引起的。
==副作用==
阿米卡星的[[副作用]]与其他[[氨基糖苷类抗生素]]相似,肾毒性和耳毒性是主要的副作用。因此给药期间应监测血药浓度和肾功能。


==註釋==
== 參考文獻 ==
{{reflist}}
{{reflist|2}}


{{模板:皮膚病用抗生素和化療藥}}
==外部連結==
{{模板:蛋白質合成抑制劑類抗生素}}
{{wikisource|司法院釋字第767號解釋}}
{{Portal bar | Medicine}}
*[https://www.drugbank.ca/drugs/DB00479 Amikacin - DrugBank ]
{{Authority control}}
*[https://www.rxlist.com/amikin-drug.htm Amikin (Amikacin): Side Effects, Interactions, Warning, Dosage & Uses]
*[http://www.ktgh.com.tw/Medicament_tbDrug_Look.asp?CatID=65&ModuleType=&NewsID=554&Ordid=30051 Amikacin]
*[https://www.paochien.com.tw/filemanager/getFile4?filefrom=formulary&fileid=IAMIK&uid=1 Acemycin.doc]
*[https://casebf.com/2018/07/28/j767/ 釋字767號解釋:風險社會下的困難抉擇:Amikin (Amikacin)]
{{-}}
{{国家基本药物目录/抗微生物药}}
{{抗分支杆菌药}}


[[Category:氨基糖苷抗生素]]
[[分類:氨基糖苷抗生素]]
[[分類:抗結核藥物]]
[[Category:世界卫生组织基本药物]]
[[Category:Butyramides]]
[[分類:世界衛生組織基本藥物]]
[[分類:RTT]]
[[分類:罕用藥]]

2024年9月18日 (三) 10:39的最新版本

阿米卡星
臨床資料
商品名英语Drug nomenclatureAmikin、Amiglyde-V、Arikayce及其他
AHFS/Drugs.comMonograph
MedlinePlusa682661
核准狀況
懷孕分級
给药途径肌肉注射靜脈注射及口部吸入
藥物類別英语Drug class胺基糖苷類抗生素
ATC碼
法律規範狀態
法律規範
藥物動力學數據
生物利用度>90%[7]
血漿蛋白結合率0–11%
药物代谢幾乎不會被代謝
生物半衰期2–3小時
排泄途徑
识别信息
  • (2S)-4-Amino-N-[(2S,3S,4R,5S)-5-amino-2-[(2S,3R,4S,5S,6R)-4-amino-3,5-dihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-4-[(2R,3R,4S,5R,6R)-6-(aminomethyl)-3,4,5-trihydroxy-oxan-2-yl]oxy-3-hydroxy-cyclohexyl]-2-hydroxybutanamide
CAS号37517-28-5  checkY
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard英语CompTox Chemicals Dashboard (EPA)
ECHA InfoCard100.048.653 編輯維基數據鏈接
化学信息
化学式C22H43N5O13
摩尔质量585.61 g·mol−1
3D模型(JSmol英语JSmol
  • O=C(N[C@H]3[C@H](O[C@H]1O[C@@H]([C@@H](O)[C@H](N)[C@H]1O)CO)[C@@H](O)[C@H](O[C@H]2O[C@H](CN)[C@@H](O)[C@H](O)[C@H]2O)[C@@H](N)C3)[C@@H](O)CCN
  • InChI=1S/C22H43N5O13/c23-2-1-8(29)20(36)27-7-3-6(25)18(39-22-16(34)15(33)13(31)9(4-24)37-22)17(35)19(7)40-21-14(32)11(26)12(30)10(5-28)38-21/h6-19,21-22,28-35H,1-5,23-26H2,(H,27,36)/t6-,7+,8-,9+,10+,11-,12+,13+,14+,15-,16+,17-,18+,19-,21+,22+/m0/s1 checkY
  • Key:LKCWBDHBTVXHDL-RMDFUYIESA-N checkY

阿米卡星(英語:Amikacin)是一種抗生素藥物,用於治療多種病原細菌感染,[8]包括敗血性關節炎腹腔內感染英语intra-abdominal infection腦膜炎肺炎敗血症泌尿道感染[8]它也用於治療多重抗藥性結核病英语Multidrug-resistant tuberculosis[9]此藥物經由靜脈注射肌肉注射及口部吸入方式使用。[8]

阿米卡星與其他胺基糖苷類藥物一樣,會導致聽力損失、身體平衡問題和腎功能衰竭[8]其他的副作用有癱瘓(導致無法呼吸)。[8]如果個體在懷孕期間使用,出生的後代可能會永久性失聰。[8][1]阿米卡星是透過阻斷細菌30S核糖體亞基的功能,使其無法產生蛋白質而發揮作用。[8]

醫療用途

[编辑]

阿米卡星最常用於治療嚴重性多重抗藥性與需氧革蘭氏陰性菌的感染,後者細菌特別指假單胞菌屬不動桿菌屬腸桿菌屬大腸桿菌變形桿菌屬克雷伯氏菌屬沙雷氏菌屬[10]少數會受阿米卡星強烈影響的革蘭氏陽性菌葡萄球菌屬[10]諾卡氏菌屬兩種。 [11]在第一線藥物無法控制非結核分枝桿菌屬感染和結核病感染(且如果是對阿米卡星效力敏感的菌株所引起)時,也可使用阿米卡星治療。[8]此種藥物在治療時很少會單獨使用。[12]

阿米卡星常用於治療下述疾病:[8]

阿米卡星可與β-內酰胺類抗生素聯合針對嗜中性白血球低下發燒患者進行經驗治療英语empiric therapy[8]

懸浮液吸入劑

[编辑]

美國[16][4]歐盟[5]也批准使用含阿米卡星的脂質體懸浮液吸入劑,用於治療鳥分枝菌群感染。

特定人口群組

[编辑]

對於老年人和兒童,由於老年人通常會出現隨年齡增長而有的腎功能下降,而兒童則為腎臟尚未發育完全,而應採小劑量治療方式。此藥物在美國和澳大利亞被歸類為妊娠類別D,表示有可能會傷害胎兒。[16]

阿米卡星於人體內的分布容積、清除率以及對特殊人群的影響如下述:

  • 一般來說,應避免將阿米卡星用於嬰兒身上。[17]嬰兒由於細胞外液濃度較高,其藥物分布容積也往往更大,會含有更多胺基糖苷類藥物。[7]
  • 阿米卡星於老年人體內的停留時間往往更長。 20歲患者的阿米卡星平均清除率為每小時6升,而80歲患者則為每小時3升。[18]
  • 囊腫性纖維化患者的清除率則更高。[19]
  • 對於患有肌肉疾患,如重症肌無力症帕金森氏症等的患者,阿米卡星的神經肌肉銜接阻滯作用可能會加劇肌肉無力症状。[8]

不良影響

[编辑]

阿米卡星的副作用與其他胺基糖苷類藥物相似。腎毒性英语Nephrotoxicity耳毒性英语ototoxicity(可導致聽力損失)是最重要的影響,會發生在1-10%的使用者身上。[13]腎毒性和耳毒性被認為是由於胺基糖苷類藥物容易在腎臟和內耳中累積所致。[7]

人類內耳圖,阿卡米星會對耳蝸耳前庭造成損害。

如果使用較高劑量或使用時間超過建議時,可能會導致神經毒性。

含阿米卡星脂質體懸浮液吸入劑的處方資訊中列有黑框警告,指出使用將涉及有關呼吸系統疾病風險增加,包括過敏性肺炎、支氣管痙攣、潛在肺部疾病惡化和咳血,且在某些情況下需住院治療。[16][4]使用此類吸入劑的患者的其他常見副作用有聲音嘶啞咳嗽、耳毒性、上呼吸道不適、肌肉骨骼疼痛、疲勞、腹瀉噁心[16][4]

禁忌症

[编辑]

對任何胺基糖苷類藥物敏感的患者應避免使用,因為阿米卡星會引發交叉過敏性。對亞硫酸鹽敏感的人也應避免使用(在氣喘患者中更為常見),[10]因為大多數阿米卡星通常含有焦亞硫酸鈉,可能會引起過敏反應。[8]

一般來說,阿米卡星不應與另一種可引起神經毒性、耳毒性或腎毒性的藥物一起使用,或在其之前/之後使用。此類藥物包括其他胺基糖苷類藥物、阿昔洛韋(抗病毒)、兩性黴素B(抗真菌)、桿菌肽(抗生素)、捲曲黴素英语capreomycin粘菌素多粘菌素B萬古黴素,以及用於化學療法順鉑[8]

阿米卡星不應與神經肌肉阻滯藥一起使用,因為它們會加劇肌肉無力和癱瘓。[8]

藥物交互作用

[编辑]

阿米卡星可被其他β-內酰胺類藥物滅活,但程度不如其他胺基糖苷類藥物,而仍經常與青黴素(一種β-內酰胺類藥物)和碳青黴烯類藥物一起使用,以產生針對某些細菌的附加作用。已知抗生素氯黴素、克林黴素和四環黴素通常透過藥理拮抗作用讓胺基糖苷類藥物失去活性。[8]

阿米卡星的藥理拮抗劑作用會降低某些疫苗的效果,例如活的減毒卡介苗(用於預防結核病)、霍亂疫苗和口服減活傷寒疫苗[13]

藥理學

[编辑]

作用機制

[编辑]
原核生物30S核糖體亞基。圖中,橙色部分代表16S 核糖體RNA,藍色部分代表附着的各種蛋白質。

阿米卡星不可逆地與16S 核糖體RNA和30S核糖體亞基的RNA結合S12蛋白結合,並透過改變核醣體的形狀來抑制蛋白質合成,使其無法正確讀取信使核糖核酸遺傳密碼[10][20]它也干擾與轉運核糖核酸(tRNA)反遺傳密碼搖擺鹼基對相互作用的區域。[21]其作用有濃度依賴性,在鹼性環境下作用較佳。[7]

在正常劑量下,會在24-48小時內對具有阿米卡星敏感性的細菌發生作用。[10]

抗藥性

[编辑]

阿米卡星可避開所有抗生素失活酶的攻擊,而這些酶會導致細菌對抗生素產生抗藥性,但氨基乙醯轉移酶和核苷酸轉移酶兩者除外。[22]

藥物動力學

[编辑]

阿米卡星無法經由口服方式吸收,因此必須經由腸胃外給藥。於肌肉注射時,它在0.5-2小時內達到血清濃度的峰值。不到11%的阿米卡星會與血漿蛋白結合,分佈在心臟膽囊、肺和骨骼中,以及膽汁、組織液、胸膜液和滑液之中。

化學

[编辑]

阿米卡星由卡那黴素衍生而來。[23][24]

阿米卡星由卡那黴素衍生而來的過程
阿米卡星由卡那黴素衍生而來的過程

社會與文化

[编辑]

阿米卡星於1971年由禮來公司提出申請,於1972年獲得專利,並於1976年進入商業販售。[25][26]它已被列入世界衛生組織基本藥物標準清單之中。[27]

獸醫用途

[编辑]

雖然阿米卡星獲得美國食品藥物管理局(FDA)批准,僅適用於治療狗和馬的子宮內感染,但它是獸醫學中最常使用的氨基糖苷類藥物之一,[28]並已用於狗、貓、豚鼠絨鼠倉鼠小鼠土撥鼠家牛烏龜陸龜鱷魚牛蛙的治療。[7][29][30]它常用於治療蛇的呼吸道感染、烏龜的細菌性甲殼病和金剛鸚鵡鼻竇炎。它通常禁用於家和野兔(但仍被使用),因為它會損害兔類腸道菌群的平衡。[7]

對於狗和貓,阿米卡星通常用作外用抗生素,治療耳炎和角膜潰瘍,尤其是綠膿桿菌引起的。

參考文獻

[编辑]
  1. ^ 1.0 1.1 Amikacin Use During Pregnancy. Drugs.com. 2019-12-02 [2020-03-13]. (原始内容存档于2020-07-25). 
  2. ^ Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017. Therapeutic Goods Administration (TGA). 21 June 2022 [2024-03-30]. (原始内容存档于2023-07-06). 
  3. ^ Amikacin 250 mg/ml Injection - Summary of Product Characteristics (SmPC). (emc). 16 September 2015 [2020-03-13]. (原始内容存档于2020-03-13). 
  4. ^ 4.0 4.1 4.2 4.3 Arikayce- amikacin suspension. DailyMed. 2018-09-30 [2020-03-13]. (原始内容存档于2020-03-13). 
  5. ^ 5.0 5.1 Arikayce liposomal EPAR. European Medicines Agency. 21 July 2020 [2023-03-04]. (原始内容存档于2023-09-24). 
  6. ^ Arikayce liposomal Product information. Union Register of medicinal products. [2023-03-03]. (原始内容存档于2023-03-05). 
  7. ^ 7.0 7.1 7.2 7.3 7.4 7.5 Plumb DC. Amikacin Sulfate. Plumb's Veterinary Drug Handbook 7th. Stockholm, Wisconsin; Ames, Iowa: Wiley. 2011: 39–43. ISBN 978-0-470-95964-0. 
  8. ^ 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 8.12 8.13 8.14 Amikacin Sulfate. The American Society of Health-System Pharmacists. [2016-12-08]. (原始内容存档于2016-12-20). 
  9. ^ World Health Organization. Stuart MC, Kouimtzi M, Hill SR , 编. WHO Model Formulary 2008. World Health Organization. 2009: 137. ISBN 9789241547659. hdl:10665/44053可免费查阅. 
  10. ^ 10.0 10.1 10.2 10.3 10.4 10.5 10.6 Amikacin sulfate injection, solution. DailyMed. 2019-4-10 [2020-05-13]. (原始内容存档于2020-03-13). 
  11. ^ Scholar EM, Pratt WB. The Antimicrobial Drugs 2nd. Oxford University Press, USA. 2000-05-22: 15–19. ISBN 978-0-19-975971-2. (原始内容存档于2017-09-10). 
  12. ^ Cunha BA. New uses for older antibiotics: nitrofurantoin, amikacin, colistin, polymyxin B, doxycycline, and minocycline revisited. The Medical Clinics of North America. Antimicrobial Therapy. November 2006, 90 (6): 1089–1107. PMID 17116438. S2CID 30373734. doi:10.1016/j.mcna.2006.07.006. 
  13. ^ 13.0 13.1 13.2 amikacin (Rx). Medscape. WebMD. [2017-08-09]. (原始内容存档于2017-08-09). 
  14. ^ Aronson J. K. (编). Amikacin. Meyler's Side Effects of Drugs 16th. Oxford: Elsevier. 2016: 207–209. ISBN 978-0-444-53716-4. 
  15. ^ Vardanyan R, Hruby V. Chapter 32: Antimicobacterial Drugs. Synthesis of Best-Seller Drugs. Boston: Academic Press. 2016: 669–675. ISBN 978-0-12-411492-0. 
  16. ^ 16.0 16.1 16.2 16.3 FDA approves a new antibacterial drug to treat a serious lung disease using a novel pathway to spur innovation. U.S. Food and Drug Administration (FDA) (新闻稿). [2018-11-12]. (原始内容存档于2019-10-01).  公有领域 本文含有此來源中屬於公有领域的内容。
  17. ^ Ettinger SJ, Feldman EC. Textbook of Veterinary Internal Medicine. Elsevier Health Sciences. 2009-12-24: 1976, 523. ISBN 978-1-4377-0282-8. (原始内容存档于2017-09-10). 
  18. ^ Maire P, Bourguignon L, Goutelle S, Ducher M, Jelliffe R. Chapter 20 – Individualizing Drug Therapy in the Elderly. Jelliffe RW, Neely M (编). Individualized Drug Therapy for Patients. Boston: Academic Press. 2017: 373–382. ISBN 978-0-12-803348-7. 
  19. ^ Eghianruwa K. Essential Drug Data for Rational Therapy in Veterinary Practice. Author House. 2014: 16. ISBN 978-1-4918-0000-3. (原始内容存档于2017-09-10). 
  20. ^ Bauman RW. Microbiology: with diseases by body system 4th. Boston: Pearson. 2015. ISBN 978-0-321-91855-0. 
  21. ^ Amikacin. DrugBank. 2017-08-02 [2017-08-10]. (原始内容存档于2017-08-16). 
  22. ^ Mudd E. O Aminoglycosides. Pharmacological Sciences. 2017-08-07 [2017-08-14]. (原始内容存档于2017-08-16). 
  23. ^ Kawaguchi H, Naito T, Nakagawa S, Fujisawa KI. BB-K 8, a new semisynthetic aminoglycoside antibiotic. The Journal of Antibiotics. December 1972, 25 (12): 695–708. PMID 4568692. doi:10.7164/antibiotics.25.695可免费查阅. (原始内容存档于2017-08-16). 
  24. ^ Monteleone PM, Muhammad N, Brown RD, McGrory JP, Hanna SA. Amikacin Sulfate. Analytical Profiles of Drug Substances 12. Academic Press. 1983-01-01: 37–71. ISBN 9780122608124. ISSN 0099-5428. doi:10.1016/S0099-5428(08)60163-X. 
  25. ^ Fischer J, Ganellin CR. Analogue-based Drug Discovery. John Wiley & Sons. 2006: 507. ISBN 9783527607495. (原始内容存档于2016-12-20). 
  26. ^ Oxford Handbook of Infectious Diseases and Microbiology. OUP Oxford. 2009: 56. ISBN 9780191039621. (原始内容存档于2015-11-24). 
  27. ^ World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. hdl:10665/325771可免费查阅. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO. 
  28. ^ Forney B. Amikacin for Veterinary Use. Wedgewood Pharmacy. [2017-08-09]. (原始内容存档于2017-08-16). 
  29. ^ Riviere JE, Papich MG. Veterinary Pharmacology and Therapeutics. John Wiley & Sons. 2013-05-13: 931. ISBN 978-1-118-68590-7. (原始内容存档于2017-09-10). 
  30. ^ Mader DR, Divers SJ. Current Therapy in Reptile Medicine and Surgery – E-Book. Elsevier Health Sciences. 2013-12-12: 382. ISBN 978-0-323-24293-6. (原始内容存档于2017-09-10).