【药物别名】硫酸妥布霉素滴眼液 Tobramycin Sulfate 　　

【分子式成分】每毫升滴眼液含0.3%妥布霉素3mg及0.01%氯苄烷胺作为保存剂。妥布霉素的化学名为o-3-氨基-3-脱氧-α-D-吡喃糖基-(1-6)-o-[2.6-二氧基-2，3，6-三脱氧-α-D-已核糖吡喃基(1-4)-2-脱氧-D-链酶胺]。分子式为C18H37N5O9，分子量为467.52。本品为无色或几乎无色的澄明液体。 　　

【药理毒理】
抗菌谱与庆大霉素近似，主要包括革兰氏阴性杆菌，如绿脓杆菌、大肠杆菌、克雷白杆菌、肠杆菌属、吲哚阴性和阳性变形杆菌、枸橼酸杆菌和普鲁威登菌。对于绿脓杆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绿脓杆菌对本品高度敏感。但对其它革兰氏阴性菌，本品的作用则低于庆大霉素。对金黄色葡萄球菌有抗菌作用，对链球菌无效。与庆大霉素间存在交叉耐药性。 　　

【适 应 证】敏感菌株引起的成人及儿童外眼及附属器感染。 　　

【不良反应】偶见眼睑发痒与红肿、结膜充血。 　　

【用法用量】滴眼液：轻度及中度感染，每4h 1～2滴，滴入患眼；重度感染者，2滴/h。眼膏：适量涂入患眼结膜眼囊内，一般2～3次/日，重症每3～4h 1次。

【注意事项】
1. 肾功能不全、肝功能异常、前庭功能或听力减退者、失水、重症肌无力或帕金森病及老年患者慎用。
2. 交叉过敏：对一种氨基糖苷类抗生素如链霉素、庆大霉素过敏的患者，可能对本品过敏。若出现过敏反应，应立即停药。 　　
3. 长期应用本品可能导致耐药菌过度生长，甚至引起真菌感染。 　　
4. 若患者同时接受氨基糖苷类抗生素的全身用药，应监测本品及氨基糖苷类抗生素的血药浓度。 　　
5．保持瓶口周围的清洁，防止污染。 　　
6.对诊断的干扰：本品可能使丙氨酸氨基转移酶、门冬氨酸氨基转移酶、血清胆红素浓度及血清乳酸脱氢酶浓度的测定值增高；血钙、镁、钾、钠浓度的测定值可能降低。

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.