Vol 10, No 3 (2006)
Original paper
Published online: 2006-06-05
Hypotonia during amikacine administration in a patient treated with continuous ambulatory peritoneal dialysis
Maria Wanic-Kossowska, Alicja Grzegorzewska, Anna Posadzy-Małaczyńska, Andrzej Tykarski, Mikołaj Kobelski, Paweł Bączyk, Lidia Kozioł, Stanisław Czekalski
Nadciśnienie tętnicze 2006;10(3):211-214.
Vol 10, No 3 (2006)
Prace oryginalne
Published online: 2006-06-05
Abstract
The prevalence of hypotonia in patients on continuous
ambulatory peritoneal dialysis (CADO) is about 12%, and
its pathophysiology is complex. The study presents a case
of a patient on CADO, whose episodes of low blood pressure
may be associated with the use of antibiotic amikacine
(group of aminoglycosides). Female, aged 68, was admitted
to the Clinic for CADO treatment of the renal failure.
In the first week after the catheter implantation the patient
complained of dysuric symptoms. Due to significant E.
coli bacteriuria 250 mg amikacine and 1 g cefazolin was
introduced according to antibiogram. In the third day of
antibioticotherapy the patient fainted with the blood pressure
of 90/60 mm Hg. In the following days the patient
presented blood pressure falls to the values of 90/60–80/50
mm Hg 2- or 3-times a day. The patient was feeling ill. All
anti-hypertensives were stopped. In the repeated urinalysis
leukocyturia was not found. Two days following the cessation
of antibiotics patient’s state improved and the episodes
of hypotonia disappeared. Blood pressure values increased
and amlodipine and perindopril treatment was introduced
in previously used doses. The mechanism of the
hypotensive effect of aminoglycosides remains unclear.
One of the hypotheses assumes that aminoglycosides are one of ligands with the affinity to bind at calcium receptor
and may influence the parathormone (PTH) and parathyroid
hypertensive factor (PHF) via this path. The
hypotensive effect could be indirectly associated with the
lowered membrane calcium concentration. The blood
pressure fall observed after intravenous administration of
amikacine may be with high probability associated with
calcimimetric operation of the aminoglycoside and simultaneous
PHF inhibition.
Abstract
The prevalence of hypotonia in patients on continuous
ambulatory peritoneal dialysis (CADO) is about 12%, and
its pathophysiology is complex. The study presents a case
of a patient on CADO, whose episodes of low blood pressure
may be associated with the use of antibiotic amikacine
(group of aminoglycosides). Female, aged 68, was admitted
to the Clinic for CADO treatment of the renal failure.
In the first week after the catheter implantation the patient
complained of dysuric symptoms. Due to significant E.
coli bacteriuria 250 mg amikacine and 1 g cefazolin was
introduced according to antibiogram. In the third day of
antibioticotherapy the patient fainted with the blood pressure
of 90/60 mm Hg. In the following days the patient
presented blood pressure falls to the values of 90/60–80/50
mm Hg 2- or 3-times a day. The patient was feeling ill. All
anti-hypertensives were stopped. In the repeated urinalysis
leukocyturia was not found. Two days following the cessation
of antibiotics patient’s state improved and the episodes
of hypotonia disappeared. Blood pressure values increased
and amlodipine and perindopril treatment was introduced
in previously used doses. The mechanism of the
hypotensive effect of aminoglycosides remains unclear.
One of the hypotheses assumes that aminoglycosides are one of ligands with the affinity to bind at calcium receptor
and may influence the parathormone (PTH) and parathyroid
hypertensive factor (PHF) via this path. The
hypotensive effect could be indirectly associated with the
lowered membrane calcium concentration. The blood
pressure fall observed after intravenous administration of
amikacine may be with high probability associated with
calcimimetric operation of the aminoglycoside and simultaneous
PHF inhibition.
Keywords
hypotensive effect; amikacine; parathormone
Title
Hypotonia during amikacine administration in a patient treated with continuous ambulatory peritoneal dialysis
Journal
Arterial Hypertension
Issue
Vol 10, No 3 (2006)
Article type
Original paper
Pages
211-214
Published online
2006-06-05
Page views
697
Article views/downloads
1311
Bibliographic record
Nadciśnienie tętnicze 2006;10(3):211-214.
Keywords
hypotensive effect
amikacine
parathormone
Authors
Maria Wanic-Kossowska
Alicja Grzegorzewska
Anna Posadzy-Małaczyńska
Andrzej Tykarski
Mikołaj Kobelski
Paweł Bączyk
Lidia Kozioł
Stanisław Czekalski