gAlvarez, Jenifer F.

BSN II-C

August 09, 2021

NAME MECHANISM DOSAGE INDICATIO CONTRAINDI ADVERSE NURSING

OF THE OF ACTION NS CATIONS REACTION RESPONSIBILITI
DRUG ES
Generic Bactericidal:Inhi Moderate to Parenteral History of Special Senses: -Lab tests:
Name: bits Severe use hypersensitivit Ototoxicity Perform C&S and
Gentamic proteinsynthesis Infection restricted to y to or toxic (vestibular renal function
in sulfate insusceptible Adult: IV/IM treatment of reaction with disturbances, prior to first dose
ophthalmi strainsof gram- 1.5–2 mg/kg serious any impaired hearing), and periodically
c negativebacteri loading dose infections of aminoglycosid optic neuritis. CNS: during therapy;
a;appears to followed by 3–5 GI, e antibiotic. neuromuscular therapy may
Brand disruptfunctiona mg/kg/d in 2–3 respiratory, Safe use blockade: skeletal begin pending
name: l integrityof divided doses and urinary during muscle weakness, test results.
Genoptic bacterial Intrathecal 4–8 tracts, CNS, pregnancy apnea, respiratory Determine
cellmembrane, mg preservative bone, skin, (category C) or paralysis (high creatinine
causingcell free q.d. and soft lactation is not doses); arachnoiditis clearance and
death. Topical 1–2 tissue established. (intrathecal use). serum drug
drops of (including CV: hypotension or concentrations at
solution in eye burns) when hypertension. GI: frequent intervals,
q4h up to 2 other less Nausea, vomiting, particularly for
drops q1h or toxic transient increase in patients with
small amount of antimicrobial AST, ALT, and impaired renal
ointment b.i.d. agents are serum LDH and function, infants
or t.i.d. ineffective or bilirubin; (renal
Child: IV/IM 6– are hepatomegaly, immaturity), older
7.5 mg/kg/d in contraindicat splenomegaly. adults, patients
3–4 divided ed. Has Hematologic: receiving high
doses been used in Increased or doses or therapy
Intrathecal >3 combination decreased beyond 10 d,
mo, 1–2 mg with other reticulocyte counts; patients with
preservative antibiotics. granulocytopenia, fever or extensive
free q.d. Also used thrombocytopenia burns, edema,
Neonate: IV/IM topically for (fever, bleeding obesity.
2.5 mg/kg q12– primary and tendency),
24h secondary thrombocytopenic -Repeat C&S if
skin purpura, anemia. improvement
Acute Pelvic infections Body as a Whole: does not occur in
Inflammatory and for Hypersensitivity 3–5 d; reevaluate
Disease superficial (rash, pruritus, therapy.
Adult: IV/IM 2 infections of urticaria, exfoliative
mg/kg followed external eye dermatitis, -Note: Dosages
by 1.5 mg/kg and its eosinophilia, burning are generally
q8h adnexa. sensation of skin, adjusted to
drug fever, joint maintain peak
Prophylaxis of pains, laryngeal serum gentamicin
Bacterial edema, concentrations of
Endocarditis anaphylaxis). 4– 10 g/mL, and
Adult: IV/IM 1.5 Urogenital: trough
mg/kg 30 min Nephrotoxicity: concentrations of
before proteinuria, tubular 1–2 g/mL. Peak
procedure, may necrosis, cells or concentrations
repeat in 8 h casts in urine, above 12 g/mL
Child: IV/IM < hematuria, rising and trough
27 kg, 2 mg/kg BUN, nonprotein concentrations
30 min before nitrogen, serum above 2 g/mL are
procedure, may creatinine; associated with
repeat in 8 h decreased toxicity.
creatinine
clearance. Other: -Draw blood
Local irritation and specimens for
pain following IM peak serum
use; gentamicin
thrombophlebitis,
abscess, concentration 30
superinfections, min–1h after IM
syndrome of administration,
hypocalcemia and 30 min after
(tetany, weakness, completion of a
hypokalemia, 30–60 min IV
hypomagnesemia). infusion. Draw
Topical and blood specimens
Ophthalmic: for trough levels
Photosensitivity, just before the
sensitization, next IM or IV
erythema, pruritus; dose. Use
burning, stinging, nonheparinized
and lacrimation tubes to collect
(ophthalmic blood.
formulation).
-Check baseline
weight and vital
signs; determine
vestibular and
auditory function
before therapy
and at regular
intervals. Check
vestibular and
auditory function
again 3–4 wk
after drug is
discontinued (the
time that
deafness is most
likely to occur).

-Monitor I&O.
Keep patient well
hydrated to
prevent chemical
irritation of renal
tubules. Report
oliguria, unusual
appearance of
urine, change in
I&O ratio or
pattern, and
presence of
edema (prolongs
elimination time).

-Note: Ototoxic
effect (see
Appendix F) is
greatest on the
vestibular branch
of eighth cranial
(acoustic) nerve
(symptoms:
headache,
dizziness or
vertigo, nausea
and vomiting with
motion, ataxia,
nystagmus).
However,
damage to the
auditory branch
(tinnitus, roaring
noises, sensation
of fullness in
ears, hearing
impairment) may
also occur.
Report promptly
to prevent
permanent
damage.

-Watch for S&S of

bacterial
overgrowth
(opportunistic
infections) with
resistant or
nonsusceptible
organisms
(diarrhea,
anogenital
itching, vaginal
discharge,
stomatitis,
glossitis).