Drug name Amikacin

Dosage 250 g IV q 12

Therapeutic action Inhibits protein synthesis by binding directly to the30S ribosomal sub unit ;bactericidal

Indication Primarily for shortterm treatment of serious infections of respiratory tract, bones, joints, skin, and soft tissue, CNS (including meningitis) and peritonitis burns,

Contraindication History of hypersensitivity or toxic reaction with an aminoglycoside antibiotic.

Adverse effects CNS: Neurotoxicity: drowsiness, unsteady gait, weakness, clumsiness, paresthesias, tremors, convulsions, peripheral neuritis. Vestibular: dizziness, ataxia. GI: Nausea, vomiting, hepatotoxicity. Metabolic: Hypokalemia, hypomagnesemia. Skin: Skin rash, urticaria, pruritus, redness. Urogenital: Oliguria, urinary frequency, hematuria, tubular necrosis, azotemia. Other: Superinfections.

Nursing responsibilities 1. Before initial dose, C&S; renal function and vestibulocochlear nerve function 2. Monitor peak and trough amikacin blood levels: Draw blood 1 h after IM or immediately after completion of IV infusion; draw trough levels immediately before the next IM or IV dose. 3. Monitor & report any changes in I&O, oliguria, hematuria, or cloudy urine. Keeping patient well hydrated reduces risk of nephrotoxicity; consult physician regarding optimum fluid intake. 4. Monitor for and report auditory symptoms (tinnitus, roaring noises, sensation of fullness in ears, hearing loss) and vestibular disturbances (dizziness or vertigo, nystagmus, ataxia).

Drug class: aminoglycosides