Aminoglycosides/Gentamcin Flashcards
Generalizations of Class
prevents protein synthesis, disrupts plasma membrane
narrow spectrum aerobic gram-negatives
for serious systemic infections
Pseudomonas, Enterobacteriaceae family, E. coli, Serratia, Proteus, Klebsiella
given parenterally and effect continues past drop in serum drug level
nephrotoxicity, ototoxicity, neuromuscular blockade effects
Gentamicin therapeutic class
antibacterial
pharmacologic class
protein synthesis inhibitor, aminoglycoside
pregnancy category
D
mechanism of action
inhibits bacterial protein synthesis by binding to 30S subunit; stops growing chain
indications
serious infections caused by gram-negative bacilli
few gram-positives including some strains of MRSA
contraindications
hypersensitivity to aminoglycosides
pregnany or breast feeding
precautions
impaired renal function
preexisting hearing loss
drug interactions
increased risk of nephrotoxicity with nephrotoxic drugs
increased risk of ototoxicity w/ other drugs affecting 8th cranial nerve
penicillins can inactivate solutions
antiemetics can mask signs of ototoxicity
adverse effects
rash, nausea, vomiting, fatigue
serious adverse effects
OTOTOXICITY, NEPHROTOXICITY, neuromuscular blockade, neurotoxicity, reduced kidney function, resistance
nursing responsibilities
creatinine and serum drug concentrations at intervals; draw blood for peak serum gentamicin concentration 30 mins to 1 hr after IM; 30 mins after 30-60 min IV infusion; draw blood for trough levels, check vestibular and auditory function, baseline weight, monitor I&O ratio, maintain adequate hydration, report oliguria, change in I&O, or appearance of urine; monitor for opportunistic infections
teaching
avoid direct sunlight, do not breast feed, report changes in hearing or low urinary output; report lack of improvement after 3 to 4 days; report suspected pregnancy
