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  Ãâó: ±¹¸³µ¶¼º°úÇпø µ¶¼º¹°ÁúÁ¤º¸DB : http://www.nitr.go.kr/nitr/contents/m134200/view.do  | 
   
  
   
    | Mechanism of Action | 
    
       Dexamethasone¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Dexamethasone is a glucocorticoid agonist. Unbound dexamethasone crosses cell membranes and binds with high affinity to specific cytoplasmic receptors. This results in a modification of transcription and, hence, protein synthesis in order to achieve inhibition of leukocyte infiltration at the site of inflammation, interference in the function of mediators of inflammatory response, suppression of humoral immune responses, and reduction in edema or scar tissue. The antiinflammatory actions of dexamethasone are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.
  Tobramycin¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Tobramycin binds irreversibly to one of two aminoglycoside binding sites on the 30 S ribosomal subunit, inhibiting bacterial protein synthesis. Tobramycin may also destabilize bacterial memebrane by binding to 16 S 16 S r-RNA. An active transport mechanism for aminoglycoside uptake is necessary in the bacteria in order to attain a significant intracellular concentration of tobramycin. 
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       Dexamethasone¿¡ ´ëÇÑ Pharmacology Á¤º¸ Dexamethasone and its derivatives, dexamethasone sodium phosphate and dexamethasone acetate, are synthetic glucocorticoids. Used for its antiinflammatory or immunosuppressive properties and ability to penetrate the CNS, dexamethasone is used alone to manage cerebral edema and with tobramycin to treat corticosteroid-responsive inflammatory ocular conditions.
  Tobramycin¿¡ ´ëÇÑ Pharmacology Á¤º¸ Tobramycin, an aminoglycoside antibiotic obtained from cultures of Streptomyces tenebrarius, is used in combination with other antibiotics to treat urinary tract infections, gynecologic infections, peritonitis, endocarditis, pneumonia, bacteremia and sepsis, respiratory infections including those associated with cystic fibrosis, osteomyelitis, and diabetic foot and other soft-tissue infections. 
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       Dexamethasone¿¡ ´ëÇÑ Absorption Á¤º¸ 80-90%
  Tobramycin¿¡ ´ëÇÑ Absorption Á¤º¸ Not Available 
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       Dexamethasone¿¡ ´ëÇÑ Toxicity Á¤º¸ Oral, rat LD50: >3 gm/kg. Signs of overdose include retinal toxicity, glaucoma, subcapsular cataract, gastrointestinal bleeding, pancreatitis, aseptic bone necrosis, osteoporosis, myopathies, obesity, edemas, hypertension, proteinuria, diabetes, sleep disturbances, psychiatric syndromes, delayed wound healing, atrophy and fragility of the skin, ecchymosis, and pseudotumor cerebri.
  Tobramycin¿¡ ´ëÇÑ Toxicity Á¤º¸ LD50=441mg/kg (s.c. in mice) 
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    | Drug Interactions | 
    
       Dexamethasone¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Ambenonium	The corticosteroid decreases the effect of anticholinesterasesAminoglutethimide	Aminogluthetimide decreases the effect of dexamethasoneAmobarbital	The barbiturate decreases the effect of the corticosteroidAnisindione	The corticosteroid alters the anticoagulant effectAprepitant	Aprepitant increases the effect and toxicity of dexamethasoneAprobarbital	The barbiturate decreases the effect of the corticosteroidAspirin	The corticosteroid decreases the effect of salicylatesButabarbital	The barbiturate decreases the effect of the corticosteroidButalbital	The barbiturate decreases the effect of the corticosteroidButethal	The barbiturate decreases the effect of the corticosteroidDicumarol	The corticosteroid alters the anticoagulant effectDihydroquinidine barbiturate	The barbiturate decreases the effect of the corticosteroidEdrophonium	The corticosteroid decreases the effect of anticholinesterasesEthotoin	The enzyme inducer decreases the effect of the corticosteroidFosphenytoin	The enzyme inducer decreases the effect of the corticosteroidHeptabarbital	The barbiturate decreases the effect of the corticosteroidHexobarbital	The barbiturate decreases the effect of the corticosteroidImatinib	Decreases levels of imatinibMephenytoin	The enzyme inducer decreases the effect of the corticosteroidMethohexital	The barbiturate decreases the effect of the corticosteroidMethylphenobarbital	The barbiturate decreases the effect of the corticosteroidMidodrine	Increased arterial pressureNeostigmine	The corticosteroid decreases the effect of anticholinesterasesPentobarbital	The barbiturate decreases the effect of the corticosteroidPhenobarbital	The barbiturate decreases the effect of the corticosteroidPhenytoin	The enzyme inducer decreases the effect of the corticosteroidPrimidone	The barbiturate decreases the effect of the corticosteroidPyridostigmine	The corticosteroid decreases the effect of anticholinesterasesQuinidine barbiturate	The barbiturate decreases the effect of the corticosteroidRifampin	The enzyme inducer decreases the effect of the corticosteroidSecobarbital	The barbiturate decreases the effect of the corticosteroidSunitinib	Possible decrease in sunitinib levelsTalbutal	The barbiturate decreases the effect of the corticosteroidWarfarin	The corticosteroid alters the anticoagulant effectBismuth	The corticosteroid decreases the effect of salicylatesAcenocoumarol	The corticosteroid alters the anticoagulant effectSalicylate-magnesium	The corticosteroid decreases the effect of salicylatesSalsalate	The corticosteroid decreases the effect of salicylates
  Tobramycin¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Not Available 
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    CYP450  Drug Interaction | 
    
      [CYP450 TableÁ÷Á¢Á¶È¸] 
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    | Drug Target | 
    
      
      [Drug Target]
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    | Description | 
    
       Dexamethasone¿¡ ´ëÇÑ Description Á¤º¸ An anti-inflammatory 9-fluoro-glucocorticoid. [PubChem]
  Tobramycin¿¡ ´ëÇÑ Description Á¤º¸ An aminoglycoside, broad-spectrum antibiotic produced by Streptomyces tenebrarius. It is effective against gram-negative bacteria, especially the pseudomonas species. It is a 10% component of the antibiotic complex, nebramycin, produced by the same species. [PubChem] 
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    | Dosage Form | 
    
       Dexamethasone¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Elixir	OralLiquid	IntramuscularLiquid	IntravenousLiquid	OralOintment	OphthalmicSolution	IntravenousSolution	OphthalmicSolution / drops	OphthalmicTablet	Oral
  Tobramycin¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Liquid	IntravenousLiquid	OphthalmicOintment	OphthalmicPowder, for solution	IntravenousSolution	OphthalmicSolution	Respiratory (inhalation) 
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    | Drug Category | 
    
       Dexamethasone¿¡ ´ëÇÑ Drug_Category Á¤º¸ Adrenergic AgentsAnti-inflammatory AgentsAntiemeticsAntineoplastic Agents, HormonalGlucocorticoids
  Tobramycin¿¡ ´ëÇÑ Drug_Category Á¤º¸ AminoglycosidesAnti-Bacterial Agents 
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    | Smiles String Canonical | 
    
       Dexamethasone¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ CC1CC2C3CCC4=CC(=O)C=CC4(C)C3(F)C(O)CC2(C)C1(O)C(=O)CO
  Tobramycin¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ NCC1OC(OC2C(N)CC(N)C(OC3OC(CO)C(O)C(N)C3O)C2O)C(N)CC1O 
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    | Smiles String Isomeric | 
    
       Dexamethasone¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ C[C@@H]1C[C@H]2[C@@H]3CCC4=CC(=O)C=C[C@]4(C)[C@@]3(F)[C@@H](O)C[C@]2(C)[C@@]1(O)C(=O)CO
  Tobramycin¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ NC[C@H]1O[C@H](O[C@@H]2[C@@H](N)C[C@@H](N)[C@H](O[C@H]3O[C@H](CO)[C@@H](O)[C@H](N)[C@H]3O)[C@H]2O)[C@H](N)C[C@@H]1O 
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    | InChI Identifier | 
    
       Dexamethasone¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C22H29FO5/c1-12-8-16-15-5-4-13-9-14(25)6-7-19(13,2)21(15,23)17(26)10-20(16,3)22(12,28)18(27)11-24/h6-7,9,12,15-17,24,26,28H,4-5,8,10-11H2,1-3H3/t12-,15+,16+,17+,19+,20+,21+,22+/m1/s1
  Tobramycin¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C18H37N5O9/c19-3-9-8(25)2-7(22)17(29-9)31-15-5(20)1-6(21)16(14(15)28)32-18-13(27)11(23)12(26)10(4-24)30-18/h5-18,24-28H,1-4,19-23H2/t5-,6+,7+,8-,9+,10+,11-,12+,13+,14-,15+,16-,17+,18+/m0/s1 
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    | Chemical IUPAC Name | 
    
       Dexamethasone¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ (8S,9R,10S,11S,13S,14S,16R,17R)-9-fluoro-11,17-dihydroxy-17-(2-hydroxyacetyl)-10,13,16-trimethyl-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthren-3-one
  Tobramycin¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ 4-amino-2-[4,6-diamino-3-[3-amino-6-(aminomethyl)-5-hydroxyoxan-2-yl]oxy-2-hydroxycyclohexyl]oxy-6-(hydroxymethyl)oxane-3,5-diol 
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    | Drug-Induced Toxicity Related Proteins | 
    
      DEXAMETHASONE ÀÇ Drug-Induced Toxicity Related ProteinÁ¤º¸ Replated Protein:Brain-cadherin (BR-cadherin) Drug:dexamethasone Toxicity:osteoblast differentiation.  [¹Ù·Î°¡±â] Replated Protein:Glucocorticoid-induced leucine zipper (GILZ) Drug:dexamethasone Toxicity:apoptosis.  [¹Ù·Î°¡±â] Replated Protein:Signal transducer and activator of transcription 3 Drug:dexamethasone Toxicity:apoptosis.  [¹Ù·Î°¡±â] Replated Protein:Heme oxygenase 1 Drug:dexamethasone Toxicity:oxidative injury.  [¹Ù·Î°¡±â] Replated Protein:Alkaline phosphatase Drug:dexamethasone Toxicity:osteoblast differentiation.  [¹Ù·Î°¡±â] Replated Protein:Interleukin-6  Drug:dexamethasone Toxicity:apoptosis.  [¹Ù·Î°¡±â] Replated Protein:Ornithine decarboxylase  Drug:dexamethasone Toxicity:pathogenesis of peptic ulcers.  [¹Ù·Î°¡±â] Replated Protein:Aromatic-L-amino-acid decarboxylase  Drug:dexamethasone Toxicity:pathogenesis of peptic ulcers.  [¹Ù·Î°¡±â] Replated Protein:Interleukin-4  Drug:dexamethasone Toxicity:dexamethasone-induced differentiation of mouse myeloid leukemia cells.  [¹Ù·Î°¡±â] Replated Protein:Gastrin Drug:dexamethasone Toxicity:pathogenesis of peptic ulcers.  [¹Ù·Î°¡±â] Replated Protein:Interleukin-4  Drug:dexamethasone Toxicity:dexamethasone-induced differentiation of mouse myeloid leukemia cells.  [¹Ù·Î°¡±â] Replated Protein:Cadherin-11  Drug:dexamethasone Toxicity:osteoblast differentiation.  [¹Ù·Î°¡±â] Replated Protein:Haptoglobin  Drug:dexamethasone Toxicity:hepatic lipidosis(fatty liver).  [¹Ù·Î°¡±â] Replated Protein:Interferon alpha-7  Drug:dexamethasone Toxicity:apoptosis.  [¹Ù·Î°¡±â] Replated Protein:C-jun-amino-terminal kinase-interacting protein  Drug:dexamethasone Toxicity:apoptosis of multiple myeloma cells.  [¹Ù·Î°¡±â] Replated Protein:Mitogen-activated protein kinase Drug:dexamethasone Toxicity:Dex-induced apoptosis.  [¹Ù·Î°¡±â] Replated Protein:Cadherin-4  Drug:dexamethasone Toxicity:osteoblast differentiation.  [¹Ù·Î°¡±â] Replated Protein:Glucose transporter 4 Drug:dexamethasone Toxicity:cushing's syndrome.  [¹Ù·Î°¡±â] Replated Protein:Nuclear factor NF-kappa-B Drug:dexamethasone Toxicity:pulmonary inflammation.  [¹Ù·Î°¡±â] Replated Protein:Signal transducer and activator of transcription 3 Drug:dexamethasone Toxicity:oxidative injury such as endotoxins and heme.  [¹Ù·Î°¡±â] Replated Protein:Thrombomodulin  Drug:dexamethasone  Toxicity:deep venous thrombosis (DVT).  [¹Ù·Î°¡±â] Replated Protein:Islet amyloid polypeptide Drug:dexamethasone  Toxicity:marked stimulatory effect.  [¹Ù·Î°¡±â] TOBRAMYCIN ÀÇ Drug-Induced Toxicity Related ProteinÁ¤º¸ Replated Protein:Lysozyme  Drug:tobramycin Toxicity:nephrotoxicity.  [¹Ù·Î°¡±â] Replated Protein:phospholipases C Drug:tobramycin Toxicity:aminoglycoside toxicity.  [¹Ù·Î°¡±â] Replated Protein:Phospholipase A Drug:tobramycin Toxicity:aminoglycoside toxicity.  [¹Ù·Î°¡±â] Replated Protein:Lactate dehydrogenase  Drug:tobramycin Toxicity:nephrotoxicity.  [¹Ù·Î°¡±â] 
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