University Of Luzon

University of Luzon COLLEGE OF NURSING

Name of Patient: _____________________________________________ Hospital: __________________________________________________ Chief Complaint/s: ___________________________________________

Age:____________

Sex:________ Ward/Area:_________________________

Diagnosis:_________________________

Date of Admission:______________

DRUG STUDY GENERIC NAME

BRAND NAME

DOSAGE, ROUTE & FREQUENCY

Garamycin, Gentamycin Moderate to Garamycin Sulfate Severe Ophthalmic, Infection Genopti Adult: IV/IM 1.5–2 mg/kg loading dose followed by 3– 5 mg/kg/d in 2–3 divided dosage. Intrathecal 4–8 mg preservative free q.d. Topical 1–2 drops of solution in eye q4h up to 2 drops q1h or small amount of ointment b.i.d. or t.i.d. Child: IV/IM 6–7.5 mg/kg/d

INDICATION

ACTION

Parenteral use restricted to treatment of serious infections of GI, respiratory, and urinary tracts, CNS, bone, skin, and soft tissue (including burns) when other less toxic antimicrobial agents are ineffective or are contraindicated. Has been used in combination with other antibiotics. Also used topically for primary and

Broad-spectrum aminoglycoside antibiotic derived from Micromonospora purpurea. Action is usually bacteriocida

ADVERSE REACTIONS Special Senses: Ototoxicity (vestibular disturbances, impaired hearing), optic neuritis. CNS: neuromuscular blockade: skeletal muscle weakness, apnea, respiratory paralysis (high doses); arachnoiditis (intrathecal use). CV: hypotension or hypertension. GI: Nausea, vomiting, transient increase in AST, ALT, and serum LDH and bilirubin; hepatomegaly, splenomegaly.

INTERACTION CONTRAINDICATION

History of hypersensitivity to or toxic reaction with any aminoglycoside antibiotic. Safe use during pregnancy (category C) or lactation is not established

NURSING IMPLICATION

Assessment & Drug Effects •Lab tests: Perform C&S and renal function prior to first dose and periodicall y during therapy; therapy may begin pending test results. Determine creatinine clearance and serum drug concentrati ons at

PATIENT TEACHING

in 3–4 divided doses Intrathecal >3 mo, 1–2 mg preservative free q.d. Neonate: IV/IM 2.5 mg/kg q12–24h Acute Pelvic Inflammatory Disease Adult: IV/IM 2 mg/kg followed by 1.5 mg/kg q8h Prophylaxis of Bacterial Endocarditis Adult: IV/IM 1.5 mg/kg 30 min before procedure, may repeat in 8 h Child: IV/IM < 27 kg, 2 mg/kg 30 min before procedure, may repeat in 8 h

secondary skin infections and for superficial infections of external eye and its adnexa

Hematologic: Increased or decreased reticulocyte counts; granulocytopenia, thrombocytopenia (fever, bleeding tendency), thrombocytopenic purpura, anemia. Body as a Whole: Hypersensitivity (rash, pruritus, urticaria, exfoliative dermatitis, eosinophilia, burning sensation of skin, drug fever, joint pains, laryngeal edema, anaphylaxis). Urogenital: Nephrotoxicity: proteinuria, tubular necrosis, cells or casts in urine, hematuria, rising BUN, nonprotein nitrogen, serum creatinine; decreased creatinine clearance. Other: Local irritation and pain following IM use;

frequent intervals, particularly for patients with impaired renal function, infants (renal immaturity ), older adults, patients receiving high doses or therapy beyond 10 d, patients with fever or extensive burns, edema, obesity. •Repeat C&S if improveme nt does not occur in 3– 5 d; reevaluate therapy. •Note: Dosages are generally

thrombophlebitis, abscess, superinfections, syndrome of hypocalcemia (tetany, weakness, hypokalemia, hypomagnesemia).

adjusted to maintain peak serum gentamicin concentrati ons of 4– 10 g/mL, and trough concentrati ons of 1–2 g/mL. Peak concentrati ons above 12 g/mL and trough concentrati ons above 2 g/mL are associated with toxicity. •Draw blood specimens for peak serum gentamicin concentrati on 30 min– 1h after IM administrat ion, and 30 min after completion of a 30–60 min IV infusion. Draw blood

specimens for trough levels just before the next IM or IV dose. Use nonheparin ized tubes to collect blood.

Submitted by: _____________________________________ Course & Year: __________________

Submitted to: ___________________________________ (Clinical Instructor) Date: __________________