what is gentamicin used for
it is an aminoglycoside antibiotic used for:
septicaemia meningitis and other CNS infections biliary-tract infection acute pyelonephritis, endocarditis, pneumonia in hospital patient prostatitis
what are the contraindications for gentamicin
- via injection: myasthenia gravis
when used in the ear:
- patent grommet ( grommet is a tiny tube inserted into the eardrum to allow air to enter the middle ear)
- perforated tympanic membrane (burst ear drum)
what are the cautions for gentamicin
dose related side effects, conditions with muscular weakness, correct dehydration before starting, Auditory disorder
can gentamicin be given during pregnancy
avoid due to risk of auditory and vestibular
nerve damage in infant when used in second and third trimester
what monitoring is needed for patients taking gentamicin
- serum concentration in renal impairment as drug excreted through the kidney
- auditory and vestibular function
what is the ideal therapeutic range (dose) for gentamicin
- 5-10mg/L “peak”
- 2mg/L “trough”
what are the symptoms of gentamicin toxicity
Nephrotoxicity and irreversible ototoxicity
what is the risk when patients with mitochondrial mutations are given gentamicin
increased risk of deafness
why should you monitor patients taking gentamicin for signs of histamine-related adverse reactions
some batches of gentamicin may contain higher than expected levels of histamine
when should the Serum aminoglycoside concentration be measured for gentamicin
- after 3 or 4 doses of a multiple daily dose regimen
and
- after a dose change
describe when the “peak” concentration of gentamicin is taken
approximately 1 hour after I.V/I.M administration
describe when the “trough” concentration of gentamicin is taken
just before the next dose
also known as “pre-dose trough”
what should you do if the PRE-DOSE (‘trough’) concentration of gentamicin is high
the interval between doses must be increased
what should you do If the POST-DOSE (‘peak’) concentration is high
the dose must be decreased.
