DDInter1822 DDInter676
Aminoglycosides, many of which are derived directly from _Streptomyces_ spp., are concentration-dependent bactericidal antibiotics with a broad spectrum of activity against Gram-positive and Gram-negative organisms. Inhaled tobramycin is notable for its use in treating chronic _Pseudomonas aeruginosa_ infections in cystic fibrosis patients, as _P. aeruginosa_ is notoriously inherently resistant to many antibiotics.[A232294, A232299, L32739] However, tobramycin can also be administered intravenously and topically to treat a variety of infections caused by susceptible bacteria.[L32744, L32749] Its use is limited in some cases by characteristic toxicities such as nephrotoxicity and ototoxicity, yet it remains a valuable option in the face of growing resistance to front-line antibiotics such as β-lactams and cephalosporins.[A232294, A232349, L
Esomeprazole, sold under the brand name Nexium, is a proton pump inhibitor (PPI) medication used for the management of gastroesophageal reflux disease (GERD), for gastric protection to prevent recurrence of stomach ulcers or gastric damage from chronic use of NSAIDs, and for the treatment of pathological hypersecretory conditions including Zollinger-Ellison (ZE) Syndrome. It can also be found in quadruple regimens for the treatment of _H. pylori_ infections along with other antibiotics including , , and , for example.[A177271, F4498] Its efficacy is considered similar to other medications within the PPI class including , , , , and . Esomeprazole is the s-isomer of , which is a racemate of the S- and R-enantiomer. Esomeprazole has been shown to inhibit acid secretion to a similar extent as , without any significant differences between the two compounds _in vitro_. Esomeprazole exerts its stomach acid-suppressing effects by preventing the final step in gastric acid production by covalently binding to sulfhydryl groups of cysteines found on the (H+, K+)-ATPase enzyme at the secretory surface of gastric parietal cells. This effect leads to inhibition of both basal and stimulated gastric acid secretion, irrespective of the stimulus. As the binding of esomeprazole to the (H+, K+)-ATPase enzyme is irreversible and new enzyme needs to be expressed in order to resume acid secretion, esomeprazole's duration of antisecretory effect persists longer than 24 hours.[FDA Label] PPIs such as esomeprazole have also been shown to inhibit the activity of dimethylarginine dimethylaminohydrolase (DDAH), an enzyme necessary for cardiovascular health. DDAH inhibition causes a consequent accumulation of the nitric oxide synthase inhibitor asymmetric dimethylarginie (ADMA), which is thought to cause the association of PPIs with increased risk of cardiovascular events in patients with unstable coronary syndromes.[A177577, A177580] Due to their good safety profile and as several PPIs are available over the counter without a prescription, their current use in North America is widespread. Long term use of PPIs such as esomeprazole has been associated with possible adverse effects, however, including increased susceptibility to bacterial infections (including gastrointestinal _C. difficile_), reduced absorption of micronutrients such as iron and B12, and an increased risk of developing hypomagnesemia and hypocalcemia which may contribute to osteoporosis and bone fractures later in life. Rapid discontinuation of PPIs such as esomeprazole may cause a rebound effect and a short term increase in hypersecretion. Esomeprazole doses should be slowly lowered, or tapered, before discontinuing to prevent this rebound effect.
Tobramycin {u} (Compound) causes {v} (Side Effect) Ill-defined disorder
Ill-defined disorder {u} (Side Effect) is caused by {v} (Compound) Esomeprazole
Tobramycin {u} (Compound) resembles {v} (Compound) Kanamycin
Kanamycin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Esomeprazole
Tobramycin {u} (Compound) causes {v} (Side Effect) Ill-defined disorder
Ill-defined disorder {u} (Side Effect) is caused by {v} (Compound) Lansoprazole
Lansoprazole {u} (Compound) resembles {v} (Compound) Esomeprazole
Tobramycin {u} (Compound) causes {v} (Side Effect) Proteinuria
Proteinuria {u} (Side Effect) is caused by {v} (Compound) Omeprazole
Omeprazole {u} (Compound) resembles {v} (Compound) Esomeprazole
Tobramycin {u} (Compound) resembles {v} (Compound) Kanamycin
Kanamycin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Lansoprazole
Lansoprazole {u} (Compound) resembles {v} (Compound) Esomeprazole
Tobramycin {u} (Compound) resembles {v} (Compound) Paromomycin
Paromomycin {u} (Compound) resembles {v} (Compound) Kanamycin
Kanamycin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Esomeprazole
Tobramycin {u} (Compound) causes {v} (Side Effect) Proteinuria
Proteinuria {u} (Side Effect) is caused by {v} (Compound) Bortezomib
Bortezomib {u} may cause a minor interaction that can limit clinical effects when taken with {v} Esomeprazole
Tobramycin {u} (Compound) resembles {v} (Compound) Gentamicin
Gentamicin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Rabeprazole
Rabeprazole {u} (Compound) resembles {v} (Compound) Esomeprazole
Tobramycin {u} (Compound) resembles {v} (Compound) Amikacin
Amikacin {u} (Compound) resembles {v} (Compound) Neomycin
Neomycin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Esomeprazole
Tobramycin {u} (Compound) resembles {v} (Compound) Paromomycin
Paromomycin {u} (Compound) causes {v} (Side Effect) Nausea
Nausea {u} (Side Effect) is caused by {v} (Compound) Esomeprazole
Tobramycin (Compound) causes Ill-defined disorder (Side Effect) and Ill-defined disorder (Side Effect) is caused by Esomeprazole (Compound)
Tobramycin (Compound) resembles Kanamycin (Compound) and Kanamycin may cause a moderate interaction that could exacerbate diseases when taken with Esomeprazole
Tobramycin (Compound) causes Ill-defined disorder (Side Effect) and Ill-defined disorder (Side Effect) is caused by Lansoprazole (Compound) and Lansoprazole (Compound) resembles Esomeprazole (Compound)
Tobramycin (Compound) causes Proteinuria (Side Effect) and Proteinuria (Side Effect) is caused by Omeprazole (Compound) and Omeprazole (Compound) resembles Esomeprazole (Compound)
Tobramycin (Compound) resembles Kanamycin (Compound) and Kanamycin may cause a moderate interaction that could exacerbate diseases when taken with Lansoprazole and Lansoprazole (Compound) resembles Esomeprazole (Compound)
Tobramycin (Compound) resembles Paromomycin (Compound) and Paromomycin (Compound) resembles Kanamycin (Compound) and Kanamycin may cause a moderate interaction that could exacerbate diseases when taken with Esomeprazole
Tobramycin (Compound) causes Proteinuria (Side Effect) and Proteinuria (Side Effect) is caused by Bortezomib (Compound) and Bortezomib may cause a minor interaction that can limit clinical effects when taken with Esomeprazole
Tobramycin (Compound) resembles Gentamicin (Compound) and Gentamicin may cause a moderate interaction that could exacerbate diseases when taken with Rabeprazole and Rabeprazole (Compound) resembles Esomeprazole (Compound)
Tobramycin (Compound) resembles Amikacin (Compound) and Amikacin (Compound) resembles Neomycin (Compound) and Neomycin may cause a moderate interaction that could exacerbate diseases when taken with Esomeprazole
Tobramycin (Compound) resembles Paromomycin (Compound) and Paromomycin (Compound) causes Nausea (Side Effect) and Nausea (Side Effect) is caused by Esomeprazole (Compound)