DRUG STUDY

DRUG CLASSIFICATION MECHANISM OF INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

ACTION

Gentamicin Aminoglycoside Bactericidal: Parenteral · Contraindicated with CNS: Ototoxicity— Give by IM route if at all possible;
Sulfate Inhibits protein · Serious infections allergy to any tinnitus, dizziness, give by deep IM injection.
synthesis in caused by aminoglycosides. vertigo, deafness · Culture infected area before
(Pediatric susceptible strains susceptible strains · Use cautiously with (partially reversible therapy.
Gentamicin of gram-negative of Pseudomonas renal or hepatic disease; to · Use 2 mg/mL intrathecal
Sulfate) bacteria; aeruginosa, preexisting hearing loss; irreversible), preparation without preservatives,
appears to disrupt Proteus species, active vestibular paralysis, for intrathecal use.
Dosages functional integrity Escherichia coli, infection with herpes, confusion, · Avoid long-term therapies because
ADULTS of bacterial cell Klebsiella- vaccinia, varicella, fungal disorientation, of increased risk of toxicities.
3 mg/kg/day in 3 membrane, causing Enterobacter- infections, myobacterial depression, lethargy, Reduction in
equal doses q 8 cell death. Serratia species, infections (ophthalmic nystagmus, visual dose may be clinically indicated.
hr IM or IV. Up Citrobacter, preparations); myasthenia disturbances, · Patients with edema or ascites may
to 5 mg/kg/day Staphylococcus gravis; parkinsonism; headache, have lower peak concentrations due
in 3–4 equal species infant numbness, tingling, to
doses in · Serious infections botulism; burn patients; tremor, expanded extracellular fluid volume.
severe infections. when causative lactation; pregnancy. paresthesias, muscle · Cleanse area before application of
For IV use, a organisms are not twitching, seizures, dermatologic preparations.
loading dose of known (often in muscular weakness, · Ensure adequate hydration of
1–2 mg/kg may conjunction neuromuscular patient before and during therapy.
be infused over with a penicillin or blockade · Monitor renal function tests, CBCs,
30–60 cephalosporin) · CV: Palpitations, serum drug levels during long-term
min, followed by · Unlabeled use: hypotension, therapy.
a maintenance With clindamycin hypertension Consult with prescriber to adjust
dose, usually for as alternative · GI: Hepatic dosage.
7–10 days. regimen in PID toxicity, nausea,
· PID: 2 mg/kg Intrathecal vomiting, anorexia,
IV followed by · Gram-negative weight loss,
1.5 mg/kg tid infections stomatitis,
plus clindamycin · Serious CNS increased salivation
600 mg IV qid. infections caused · GU:
Continue for at by susceptible Nephrotoxicity
least 4 days and Pseudomonas · Hematologic:
at least 48 hr species Leukemoid reaction,
after patient Ophthalmic agranulocytosis,
improves, then Preparations granulocytosis,
continue · Treatment of leukopenia,
clindamycin 450 superficial ocular leukocytosis,
mg orally qid for infections due to thrombocytopenia,
10–14 days total strains of eosinophilia,
therapy. microorganisms pancytopenia,
· Surgical susceptible to anemia, hemolytic
prophylaxis gentamicin anemia, increased or
regimens: Topical decreased
Several complex, Dermatologic reticulocyte count,
multidrug Preparation electrolyte
prophylaxis · Infection disturbances
regimens prophylaxis in · Hypersensitivity:
are available for minor skin Purpura, rash,
preoperative use; abrasions and urticaria, exfoliative
consult treatment of dermatitis, itching
manufacturer's superficial · Local: Pain,
instructions. infections of the irritation,
PEDIATRIC skin due to arachnoiditis at IM
PATIENTS susceptible injection sites
2–2.5 mg/kg q 8 organisms · Other: Fever,
hr IM or IV. amenable to local apnea,
Infants and treatment splenomegaly, joint
neonates: 2.5 Gentamicin- pain, superinfections
mg/kg q 8 hr. impregnated Ophthalmic
Premature or PMAA beads on preparations
full-term surgical wire · Local: Transient
neonates: 2.5 · Orphan drug use: irritation, burning,
mg/kg q 12 hr. Treatment of stinging, itching,
chronic angioneurotic
osteomyelitis of edema,
post-traumatic, urticaria, vesicular
postoperative, or and maculopapular
hematogenous dermatitis
origin Topical
Gentamicin dermatologic
liposome injection preparations
· Orphan drug use: · Local:
Treatment of Photosensitization,
disseminated superinfections
Myobacterium
avium-
intracellulare
infection