Pharmacology Made Easy
Medication Information Table
Aminoglycosides – gentamicin
Category
Information
THERAPEUTIC USE
• Gram-negative aerobic bacilli severe infections (all aminoglycosides).
• Gentamicin (in combination with another antibiotic) treats severe infections
that some gram-positive cocci cause.
• Topical form for skin and eye infections.
ADVERSE DRUG
REACTIONS
• Elevated trough levels of medication (early manifestations include tinnitus,
headache, and vertigo) can cause ototoxicity.
• Nephrotoxicity (polyuria, dilute urine, protein and casts in urine, elevated
BUN, creatinine)
• Ataxia
INTERVENTIONS
• Monitor for and report tinnitus and other manifestations of early ototoxicity.
• Monitor peak and trough blood levels.
• Monitor laboratory values (BUN, creatinine, urine for protein and casts) and
report elevations.
• Evaluation of eighth cranial nerve with audiometry
• Monitor I&O
ADMINISTRATION
• Available in topical, ophthalmic, IM/IV, and intrathecal forms
• Ophthalmic drops
$ Gently press the inner canthus for 1 to 2 min after instilling drops to
prevent systemic absorption.
$ Instruct the client to keep eyes shut for 1 to 2 min to maximize local
absorption.
• Topical cream
$ Don’t apply it to large skin areas.
$ There is a risk for toxicity with systemic absorption.
• IM: Inject it deeply into a large muscle.
• IV: Give it as an intermittent infusion, using recommendations for rate and
dilution.
• Intrathecal: Use a preservative-free form for intrathecal; discard portions
you didn’t use.
CLIENT INSTRUCTIONS
• Report onset of tinnitus, headache, vertigo, or hearing loss to provider.
• Report an increase in the output of dilute urine to provider.
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Pharmacology Made Easy: Medication Information Table
Aminoglycosides – gentamicin
Category
Information
CONTRAINDICATIONS
• Allergy to any aminoglycoside
• Pregnancy risk – teratogenic
PRECAUTIONS
• Prior damage to acoustic nerve causes increased risk of hearing loss
• Presence of tinnitus or vertigo
• Renal disorders
• Chronic neuromuscular disorders
• Dehydration
INTERACTIONS
• Other ototoxic medications increase the risk for ototoxicity.
• Amphotericin B, NSAIDS, or other nephrotoxic medications increase the
risk for nephrotoxicity.
• Cephalosporins, vancomycin, and penicillin enhance the bactericidal effect
of gentamicin.
• Don’t mix multiple medications in the same IV solution with gentamicin
(penicillin, cephalosporins, heparin).
• Can prolong respiratory paralysis in combination with neuromuscular
blockers (pancuronium, succinylcholine).
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