Antibiotic medications - aminoglycosides

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Selected Medications 
Depletions
Editorial Note
Supporting Research

Selected Medications 

  • Gentamicin
  • Neomycin
  • Tobramycin

Depletions

Calcium

Osteoporosis (bone loss) is the primary disease associated with long-term calcium deficiency; it may be associated with bone pain and spinal deformity. Depleted levels can also cause muscle cramps, irregular heartbeat, and depression.

Iron

Depleted levels of iron may lead to anemia and weakened immune function. In the event of anemia, symptoms include dizziness, fatigue, shortness of breath, pale skin color, and possibly irregular heartbeat.

Magnesium

Magnesium deficiency affects calcium and vitamin D levels in the body and may be associated with muscle cramps, heart irregularities, high blood pressure, diabetes, and osteoporosis (bone loss).

Nitrogen

Deficiency may impair formation of protein, which could lead to stunted growth, poor muscle development or loss of muscle mass, increased susceptibility to infection, weakness, and impaired wound healing.

Potassium

Symptoms of potassium deficiency include loss of appetite, nausea, drowsiness, feelings of apprehension, fatigue, muscle pain and weakness (usually of the lower limbs); severe cases may lead to irregular heartbeat.

Probiotics

Reducing the number of probiotic organisms, such as Lactobacillus acidophilus and Bifidobacterium bifidum, in the gastrointestinal tract may decrease the body's ability to resist infections and diseases. Symptoms of deficiency include gas, abdominal distress, diarrhea, and yeast infections.

Sodium

Because of the wide availability of sodium in dietary sources, deficiency is very uncommon. In the rare instances where it does occur, depleted levels have been associated with gas, nausea and vomiting, headache, memory impairment, diminished attention, muscle weakness, heart palpitations, lethargy, and confusion. Extreme cases can cause stupor, seizures, and possibly coma. The development of symptoms depends in large part on the rate of the loss of sodium.

Vitamin A (Retinol)

The earliest symptom of deficiency of this nutrient is night blindness. Prolonged deficiency leads to more advanced changes in eye tissue. Other potential signs of mild to moderate deficiency include rough, dry skin, loss of appetite, loss of hair luster, brittle nails, joint pain, and possibly increased susceptibility to infection.

Vitamin B12 (Cobalamin)

Obvious symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long-term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.

Vitamin K

The major symptom of vitamin K deficiency is an inability of the blood to clot properly, which may lead to excessive bleeding and a tendency to bruise easily.

Editorial Note

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle as well as the length of time you have been taking the medication. Please consult your health care provider; he or she can best assess and address your individual health care needs, and determine if you are at risk for nutrient depletions from these medications as well as others not listed here.

Supporting Research

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Beaugerie L. [Diarrhea caused by antibiotic therapy]. Rev Prat. 1996;46(2):171-176.

Bissram M, Scott FD, Liu L, Rosner MH. Risk factors for symptomatic hyponatraemia: the role of pre-existing asymptomatic hyponatraemia. Intern Med J. 2007;37(3):149-55.

Conly J, Stein K. Reduction of vitamin K2 concentrations in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med. 1994;17(6):531-539.

de Vrese M, Marteau PR. Probiotics and prebiotics: effects on diarrhea. J Nutr. 2007;137(3 Suppl 2):803S-11S.

Fitzgerald MA. Drug-induced vitamin B12 deficiency. Nurse Pract. 2007;32(9):6-7.

Fox C, Ramsoomair D, Carter C. Magnesium: its proven and potential clinical significance.South Med J. 2001;94(12):1195-201.

Gürer US, Göçer P, Erçag E, et al. The effects of some antibiotics on polymorphonuclear leukocyte functions of elderly patients in vitro before and after zinc supplementation. Int Immunopharmacol. 2006;6(5):808-16.

Hickson M, D'Souza AL, Muthu N, Rogers TR, Want S, Rajkumar C, Bulpitt CJ. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ. 2007;335(7610):80.

Hill MJ. Intestinal flora and endogenous vitamin synthesis. Eur J Cancer Prev. 1997;6(Suppl 1):S43-45.

Hussain SM, Sureshkumar KK, Marcus RJ. Recent advances in the treatment of hyponatremia. Expert Opin Pharmacother. 2007;8(16):2729-41.

Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency -- an update. Haematologica. 2006;91(11):1506-12.

Isakow W, Morrow LE, Kollef MH. Probiotics for preventing and treating nosocomial infections: review of current evidence and recommendations. Chest. 2007;132(1):286-94.

McFarland LV. Diarrhoea associated with antibiotic use. BMJ. 2007;335(7610):54-5.

Moretti R, Torre P, Antonello RM, Cazzato G, Cattaruzza T, Scapicchio PL. Vitamin B12 and folate depletion: clinical evidence in a neurological population. Neurologist. 2004;10(6):338-43.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.;2001:374-385.

Powers HJ. Current knowledge concerning optimum nutritional status of riboflavin, niacin and pyridoxine. Proc Nutr Soc. 1999;58(2):435-440.

Powers HJ. Riboflavin (vitamin B-2) and health. Am J Clin Nutr. 2003;77(6):1352-60.

Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurol. 2006;5(11):949-60.

Saavedra JM. Use of probiotics in pediatrics: rationale, mechanisms of action, and practical aspects. Nutr Clin Pract. 2007;22(3):351-65.

Svenson J. Neurologic disease and vitamin B12 deficiency. Am J Emerg Med. 2007;25(8):987.e3-4.

Vermeer C, Schurgers LJ. A comprehensive review of vitamin K and vitamin K antagonists. Hematol Oncol Clin North Am. 2000;14(2):339-353.

Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007;370(9586):511-20.

Review Date: 12/24/2007
Reviewed By: Steven D. Ehrlich, NMD, private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network. Also reviewed by Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources.
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