      Document 0046
 DOCN  DRG0046
 UNIQUE IDENTIFIER        DRG-0201
 NAME OF SUBSTANCE        Streptomycin sulfate [USAN 1996]
 REGISTRY NUMBER          3810-74-0
 STANDARD CHEMICAL NAME   D-Streptamine, O-2-deoxy-2
                          (methylamino)-alpha-L-glucopyranosyl-(1-->2)--
                          0-5-deoxy-3-C-
                          formyl-alpha-L-lyxo-furanosyl-(1-->4)-N,N'-bi-
                          s(aminoiminome thyl)-,sulfate(2:3) (salt)
                          [USAN 1996]
 SYNONYMS                 Strycin [USAN 1996]
 SYNONYMS                 Agri-Strep [Merck Index 1989]
 SYNONYMS                 Streptobrettin [Merck Index 1989]
 SYNONYMS                 Streptorex [Merck Index 1989]
 SYNONYMS                 Vetstrep [Merck Index 1989]
 SYNONYMS                 Agrimycin 17 [CHEMLINE]
 PROTOCOL ID NUMBERS      NIAID ACTG 238
 SECONDARY SOURCE ID      DRG
 PHARMACOLOGICAL ACTION   MODE OF ACTION: Interferes with protein
                          synthesis and produces faulty proteins in
                          bacteria. Streptomycin is poorly absorbed
                          from the gastrointestinal tract and instead
                          is administered parenterally. An
                          intramuscular injection will produce a peak
                          serum level of streptomycin in 30-90 minutes.
                          It is distributed to all organs except the
                          brain and can be found in pleural fluid and
                          tuberculous cavities. Umbilical cord blood
                          levels are similar to maternal levels. Small
                          amounts of the drug are excreted in breast
                          milk, saliva, and sweat. Streptomycin is
                          excreted in the urine by glomerular
                          filtration; between 29% and 89% of a single
                          600 mg dose is excreted in the urine within
                          24h. Its half-life is 2-3 hours. It is most
                          effective when used in combination with other
                          antituberculous agents. [NIAID ACTG 238] [PDR
                          1995]
 DISEASES STUDIED/TREATED Treatment of HIV-associated multi-drug
                          resistant pulmonary tuberculosis [NIAID ACTG
                          238]
 CLASSIFICATION CODE      Antibacterial [USAN 1996]
 OTHER MAJOR USES         Tuberculosis, tularemia, plague, and other
                          aminoglycoside susceptible infections [AHFS
                          Drug Information 1995]
 SUBSTANCE INTERACTIONS   Ototoxic effects are potentiated by
                          ethacrynic acid, furosemide, mannitol and
                          possibly other diuretics. [PDR 1995]
 ADVERSE EFFECTS          Adverse effects include ototoxicity and
                          nephrotoxicity. Vestibular dysfunction is
                          cumulatively related to the total daily dose.
                          Hearing loss may be temporary or permanent.
                          May also cause nausea, vomiting, fever, and
                          rash. [NIAID ACTG 238] [PDR 1995]
 CONTRAINDICATIONS        Contraindicated in patients with
                          hypersensitivity to streptomycin or to other
                          aminoglycosides. [PDR 1995]
 CHEMICAL/PHYSICAL DATA   DRUG DESCRIPTION: Aminoglycoside antibiotic
                          obtained from cultures of Streptomycin
                          griseus [AHFS Drug Information 1995]
 CHEMICAL/PHYSICAL DATA   MOLECULAR FORMULA: C42H84N14O36S3 [Merck
                          Index 1989]
 CHEMICAL/PHYSICAL DATA   MOLECULAR WEIGHT: 1457.41 [USAN 1996]
 CHEMICAL/PHYSICAL DATA   SOLUBILITY: Very soluble in water and
                          slightly soluble in alcohol [AHFS Drug
                          Information 1995]
 CHEMICAL/PHYSICAL DATA   PHYSICAL DESCRIPTION: White to light gray or
                          pale buff powder with faint amine-like odor
                          and slightly bitter taste [Merck Index 1989]
 SUBSTANCE DELIVERY DATA  DOSAGE FORM: 1 g vials. [NIAID ACTG 238]
 SUBSTANCE DELIVERY DATA  MODE OF DELIVERY: Intramuscular. [PDR 1995]
 SUBSTANCE DELIVERY DATA  STORAGE: Store under refrigeration at 2 to 8
                          C. [PDR 1995]
 MANUFACTURERS            Pfizer Incorporated / Roerig Division
 REFERENCES               Chum HJ, Ilmolelian G, Rieder HL, Msangi J,
                          Mwinyi N, Zwahlen M, Enarson DA, Ipuge YA.
                          Impact of the change from an injectable to a
                          fully oral regimen on patient adherence to
                          ambulatory tuberculosis treatment in Dar es
                          Salaam, Tanzania. Tuber Lung Dis. 1995
                          Aug;76(4):286-9.
 REFERENCES               Angarano G, Carbonara D, Costa D. Drug
                          resistance of Mycobacterium tuberculosis
                          strains isolated from HIV-infected Italian
                          patients: preliminary report from a
                          multicentric study. The Italian Tuberculosis
                          Drug Resistance Study Group. New Microbiol.
                          1995 Jan;18(1):69-72.
 REFERENCES               Okwera A, Whalen C, Byekwaso F, Vjecha M,
                          Johnson J, Huebner R, Mugerwa R, Ellner J.
                          Randomised trial of thiacetazone and
                          rifampicin-containing regimens for pulmonary
                          tuberculosis in HIV-infected Ugandans.
                          Lancet. 1994 Nov 12;344(8933):1323-8.
 REFERENCES               Angarano G, Carbonara S, Costa D.
                          Tuberculosis drug-resistance in Italian HIV+
                          subjects. Int Conf AIDS. 1994 Aug
                          7-12;10(2):169 (abstract no. PBO689).
 REFERENCES               Heym B, Honore N, Truffot-Pernot C, Banerjee
                          A, Schurra C, Jacobs WR Jr, van Embden JD,
                          Grosset JH, Cole ST. Implications of
                          multidrug resistance for the future of
                          short-course chemotherapy of tuberculosis: a
                          molecular study [see comments]. Lancet. 1994
                          Jul 30;344(8918):293-8.
 REFERENCES               Horn DL, Hewlett D Jr. Haas WH, Butler WR,
                          Alfalla C, Tan E, Levine A, Nayak A, Opal SM.
                          Superinfection with
                          rifampin-isoniazid-streptomycin-ethambutol
                          (RISE)-resistant tuberculosis in three
                          patients with AIDS: confirmation by
                          polymerase chain reaction fingerprinting. Ann
                          Inter Med. 1994 Jul 15;121(2):115-6.
 REFERENCES               Luo C, Chintu C, Bhat G, Raviglione M, Diwan
                          V, DuPont HL, Zumla A. Human immunodeficiency
                          virus type-1 infection in Zambian children
                          with tuberculosis: changing seroprevalence
                          and evaluation of a thioacetazone-free
                          regimen. Tuber Lung Dis. 1994
                          Apr;75(2):110-5.
 REFERENCES               Neville K, Bromberg A, Bromberg R, Bonk S,
                          Hanna BA, Rom WN. The third
                          epidemic--multidrug-resistant tuberculosis.
                          Chest. 1994 Jan;105(1):45-8.
 REFERENCES               Coronado VG, Beck-Sague CM, Hutton MD, Davis
                          BJ, Nicholas P, Villareal C, Woodley CL,
                          Kilburn JO, Crawford JT, Frieden TR, et al.
                          Transmission of multidrug-resistant
                          Mycobacterium tuberculosis among persons with
                          human immunodeficiency virus infection in an
                          urban hospital: epidemiologic and restriction
                          fragment length polymorphism analysis. J
                          Infect Dis. 1993 Oct;168(4):1052-5.
 REFERENCES               Githui WA, Kwamanga D, Chakaya JM, Karimi FG,
                          Waiyaki PG. Anti-tuberculous initial drug
                          resistance of Mycobacterium tuberculous in
                          Kenya: a ten-year review. East Afr Med J.
                          1993 Oct;70(10):609-12.
 ENTRY MONTH              9403
 LAST REVISION DATE       960417
 

SOURCE: National Library of Medicine, Bethesda, MD.  Distributed by AEGIS.
