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【中文名称】 妥布霉素眼膏
【产品英文名称】 Tobramycin Eye Ointment
【功效主治】 用于治疗革兰阴性杆菌，特别是绿脓杆菌所致的眼部感染性疾病。
【化学成分】 本品主要成分为妥布霉素。
【药理作用】 抗菌谱及抗菌作用与庆大霉素近似。本品的最大特点是抗绿脓杆菌作用强，为庆大霉素的2～4倍，对庆大霉素耐药的绿脓杆菌对本品仍敏感。对金萄菌的活性和庆大霉素相同。
【不良反应】 1%溶液滴眼，可明显降低角膜上皮再生。偶见局部刺激症状，如：眼睑灼痛或肿胀、结膜红斑等；罕见过敏反应。
[药物相互作用]：
1.本品与其他氨基糖苷类合用，可增加耳毒性、肾毒性以及神经肌肉阻滞作用。可能发生听力减退，停药后仍可能进展至耳聋；听力损害可能恢复或呈永久性。神经肌肉阻滞作用可导致骨骼肌软弱无力、呼吸抑制或呼吸麻痹（呼吸暂停），用抗胆碱酯酶药或钙盐有助于阻滞作用恢复。
2．本品与神经肌肉阻滞药合用，可加重神经肌肉阻滞作用，导致肌肉软弱、呼吸抑制或呼吸麻痹（呼吸暂停）。与代血浆类药如右旋糖酐、海藻酸钠，利尿药如依他尼酸、呋塞米及卷曲霉素、顺铂、万古霉素等合用，或先后连续局部或全身应用，可增加耳毒性与肾毒性，可能发生听力损害，且停药后仍可能发展至耳聋，听力损害可能恢复或呈永久性。
3．本品与头孢噻吩合用可能增加肾毒性。
4．本品与多粘菌素类合用，可增加肾毒性和神经肌肉阻滞作用，神经肌肉阻滞作用可导致骨骼肌软弱无力，呼吸抑制或呼吸麻痹（呼吸暂停）。
5．本品不宜与其他肾毒性或耳毒性药物合用或先后应用，以免出现肾毒性或耳毒性。
【禁忌症】 对本品过敏者禁用。
【规格】 滴眼剂 8m1:24mg 8ml:40mg 眼膏剂: 50mg:10g
【用法用量】
1 轻度及中度感染的患者，每日2－3次，每次取约1.5cm长的药膏涂入患眼，病情缓解后减量。
2 妥布霉素眼膏可与滴眼液联合使用，即白天滴用滴眼液，晚上使用眼膏。
【贮藏方法】 避光，密封保存。
【注意事项】
1．不能用于眼内注射。局部用氨基糖甙类抗生素可能会产生过敏反应。如果出现过敏，应停止用药。
2．与其他抗生素一样，长期应用将导致非敏感性菌株的过度生长，甚至引起真菌感染。如果出现二重感染，应及时给予适当的治疗。
[孕妇及哺乳期妇女用药]
1．孕妇：对三种动物进行的生殖实验研究，应用妥布霉素，剂量为人体全身通常用药的33倍，未出现生育力下降或胎儿损害。但目前尚无证据确凿的有关孕妇的临床研究报告，因此孕妇只有在确实必要时才可使用本品。
2．哺乳期妇女：由于哺乳时可能会产生不良反应，建议根据临床权衡利弊，或者停止哺乳或者停止用药。
[儿童用药]临床研究显示妥布霉素能安全、有效地应用于儿童患者。
【药理毒理】
本品属氨基糖苷类抗生素。抗菌谱与庆大霉素近似，对大肠埃希菌、产气杆菌、克雷白杆菌、奇异变形杆菌、某些吲哚阳性变形杆菌、铜绿假单胞菌、某些奈瑟菌、某些无色素沙雷杆菌和志贺菌等革兰阴性菌有抗菌作用；本品对铜绿假单胞菌的抗菌作用较庆大霉素强3～5倍，对庆大霉素中度敏感的铜绿假单胞菌对本品高度敏感。革兰阳性菌中，金黄色葡萄球菌（包括产?内酰胺酶株）对本品敏感；链球菌（包括化脓性链球菌、肺炎球菌、粪链球菌等）均对本品耐药。厌氧菌（拟杆菌属）、结核杆菌、立克次体、病毒和真菌亦对本品耐药。本品的作用机制是与细菌核糖体30S亚单位结合，抑制细菌蛋白质的合成。
【药代动力学】
本品滴眼后有少量被吸收进入全身血液循环。
Tobrex
Generic name: Tobramycin
What is Tobrex?
Tobrex is an antibiotic applied to the eye to treat bacterial infections.
What is the most important information I should know about Tobrex?
In order to clear up your infection completely, keep using Tobrex for the full time of treatment, even if your symptoms have disappeared.
Who should not take Tobrex?
Do not use Tobrex if you are sensitive to any component of the drug.
What should I tell my doctor before I take the first dose of Tobrex?
Mention all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Tobrex. Also, talk to your doctor about your complete medical history, especially if you have a viral or fungal infection in the eye.
What is the usual dosage?
The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.
Adults using solution: If the infection is mild or moderate, place 1-2 drops into the affected eye(s) every 4 hours. In severe infections, place 2 drops into the eye(s) every hour until there is improvement. Then you will be instructed to use less medication before you stop using it altogether.
Adults using ointment: If the infection is mild to moderate, apply a 1/2-inch ribbon into the affected eye(s) 2-3 times per day. In severe infections, apply a ½-inch ribbon into the affected eye(s) every 3-4 hours until there is improvement. Then use less medication before stopping altogether.
How should I take Tobrex?
To apply Tobrex eye drops:
Wash your hands thoroughly with soap and water.
Gently pull down your lower eyelid to form a pocket between your eye and eyelid.
Brace the bottle on the bridge of your nose or your forehead.
Do not let the applicator tip touch your eye or any other surface.
Tilt your head back and squeeze the medication into the eye.
Keep your eyes closed for 1-2 minutes.
Do not rinse the dropper.
If you are using another eye drop wait 5-10 minutes before applying it.
To apply the ointment form of this medication:
Tilt your head back.
Place a finger on your cheek just under your eye and gently pull down until a "V" pocket is formed between your eyeball and your lower lid.
Place about a half an inch of Tobrex in the "V" pocket. Do not let the tip of the tube touch the eye.
Look downward before closing your eye.
What should I avoid while taking Tobrex?
Use Tobrex exactly as prescribed by your doctor. Do not touch the dropper or tube opening to any surface, including your eyes or hands. If it becomes contaminated it could cause an infection in the eye.
Do not wear contact lenses if you have an infection in your eye or when you are applying Tobrex eye drops or ointment.
Tobrex may cause blurred vision; use caution when driving, operating machinery, or performing other hazardous activities.
What are possible food and drug interactions associated with Tobrex?
If you are taking any other prescription antibiotics for your eyes, check with your doctor before using Tobrex.
What are the possible side effects of Tobrex?
Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.
Side effects may include: abnormal redness of eye tissue, allergic reactions, lid itching, lid swelling
Can I receive Tobrex if I am pregnant or breastfeeding?
The effects of Tobrex during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.
What should I do if I miss a dose of Tobrex?
Apply it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule.
How should I store Tobrex?
Store at room temperature or in the refrigerator. Do not freeze and keep away from heat. | 
