User:Mr. Ibrahem/Colistin

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Mr. Ibrahem/Colistin
Clinical data
Trade namesXylistin, Coly Mycin M, others
AHFS/Drugs.comMonograph
Pregnancy
category
  • C
Routes of
administration		Topical, by mouth, intravenous, inhaled
Drug classAntibiotic
Legal status
Legal status
  • UK: POM (Prescription only)
  • US: not available
Pharmacokinetic data
Bioavailability0%
Elimination half-life5 hours
Identifiers
  • N-(4-amino-1-(1-(4-amino-1-oxo-1-(3,12,23-tris(2-aminoethyl)- 20-(1-hydroxyethyl)-6,9-diisobutyl-2,5,8,11,14,19,22-heptaoxo- 1,4,7,10,13,18-hexaazacyclotricosan-15-ylamino)butan-2-ylamino)- 3-hydroxybutan-2-ylamino)-1-oxobutan-2-yl)-N,5-dimethylheptanamide
Chemical and physical data
FormulaC52H98N16O13
Molar mass1155.455 g·mol−1
3D model (JSmol)
  • O=C(N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@@H]1C(=O)N[C@H](C(=O)N[C@@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)NCC1)[C@H](O)C)CCN)CCN)CC(C)C)CC(C)C)CCN)CCN)[C@H](O)C)CCN)CCCC(C)CC
  • InChI=1S/C52H98N16O13/c1-9-29(6)11-10-12-40(71)59-32(13-19-53)47(76)68-42(31(8)70)52(81)64-35(16-22-56)44(73)63-37-18-24-58-51(80)41(30(7)69)67-48(77)36(17-23-57)61-43(72)33(14-20-54)62-49(78)38(25-27(2)3)66-50(79)39(26-28(4)5)65-45(74)34(15-21-55)60-46(37)75/h27-39,41-42,69-70H,9-26,53-57H2,1-8H3,(H,58,80)(H,59,71)(H,60,75)(H,61,72)(H,62,78)(H,63,73)(H,64,81)(H,65,74)(H,66,79)(H,67,77)(H,68,76)/t29?,30-,31-,32+,33+,34+,35+,36+,37+,38+,39-,41+,42+/m1/s1 checkY
  • Key:YKQOSKADJPQZHB-QNPLFGSASA-N checkY
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Colistin, also known as polymyxin E, is an antibiotic used as a last-resort for multidrug-resistant Gram negative infections including pneumonia.[1][2] These may involve bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae, or Acinetobacter.[5] It comes in a form which can be injected into a vein or muscle or inhaled, known as colistimethate sodium and one which is applied to the skin or taken by mouth, known as colistin sulfate.[6] Resistance to colistin is beginning to appear as of 2017.[7]

Common side effects of the injectable form include kidney and neurological problems.[2] Other serious side effects may include anaphylaxis, muscle weakness, and Clostridium difficile-associated diarrhea.[2] The inhaled form may result in constriction of the bronchioles.[2] It is unclear if use during pregnancy is safe for the baby.[8] Colistin is in the polymyxin class of medications.[2] It works by breaking down the cytoplasmic membrane which generally results in bacterial cell death.[2]

Colistin was discovered in 1947 and colistimethate sodium was approved for medical use in the United States in 1970.[5][2] It is on the World Health Organization's List of Essential Medicines.[9] It is available as a generic medication.[10] Dosing is complicated and inconsistent.[11] In the United Kingdom it costs the NHS £18 for 10 vials of the injectable form (1 million units in each vial) as of 2021.[10] In the United States the dose is expressed as 'Colistin base' 150mg and costs about US$24 as of 2019.[12] It is derived from bacteria of the Paenibacillus type.[6]


References[edit]

  1. ^ a b Pogue, JM; Ortwine, JK; Kaye, KS (April 2017). "Clinical considerations for optimal use of the polymyxins: A focus on agent selection and dosing". Clinical Microbiology and Infection. 23 (4): 229–233. doi:10.1016/j.cmi.2017.02.023. PMID 28238870.
  2. ^ a b c d e f g h i "Colistimethate Sodium Monograph for Professionals". Drugs.com. Archived from the original on 6 November 2019. Retrieved 6 November 2019.
  3. ^ "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 7 August 2020. Retrieved 10 September 2020.
  4. ^ a b "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 27 November 2020. Retrieved 10 September 2020.
  5. ^ a b Falagas ME, Grammatikos AP, Michalopoulos A (October 2008). "Potential of old-generation antibiotics to address current need for new antibiotics". Expert Review of Anti-infective Therapy. 6 (5): 593–600. doi:10.1586/14787210.6.5.593. PMID 18847400.
  6. ^ a b Kaye, Keith S; Kaye, Donald (2010). "32. Polymyxins (polymyxin B and colistin)". In Bennett., John E.; Dolin, Raphael; Blaser, Martin J.; Mandell, Gerald L. (eds.). Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Vol. 1 (7th ed.). Philadelphia: Elsevier Churchill Livingstone. pp. 469–470. ISBN 9780443068393. Archived from the original on 2021-08-28. Retrieved 2020-06-05.
  7. ^ Caniaux, I; van Belkum, A; Zambardi, G; Poirel, L; Gros, MF (March 2017). "MCR: modern colistin resistance" (PDF). European Journal of Clinical Microbiology & Infectious Diseases. 36 (3): 415–420. doi:10.1007/s10096-016-2846-y. PMID 27873028. Archived (PDF) from the original on 2018-07-23. Retrieved 2019-11-23.
  8. ^ "Colistimethate (Coly Mycin M) Use During Pregnancy". Drugs.com. Archived from the original on 6 November 2019. Retrieved 11 November 2019.
  9. ^ Organization, World Health (2019). "World Health Organization model list of essential medicines: 21st list 2019" (Document). hdl:10665/325771. {{cite document}}: Cite document requires |publisher= (help)
  10. ^ a b BNF (80 ed.). BMJ Group and the Pharmaceutical Press. September 2020 – March 2021. p. 588-589. ISBN 978-0-85711-369-6.{{cite book}}: CS1 maint: date format (link)
  11. ^ Nation, Roger L; Li, Jian (December 2009). "Colistin in the 21st Century". Current opinion in infectious diseases. 22 (6): 535–543. doi:10.1097/QCO.0b013e328332e672. ISSN 0951-7375. PMID 19797945. Archived from the original on 2018-02-06. Retrieved 2021-02-02.
  12. ^ "Colistimethate Prices, Coupons & Patient Assistance Programs". Drugs.com. Archived from the original on 6 November 2019. Retrieved 11 November 2019.
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