Anti Infectives
- Aminoglycosides
Nursing management
Favorable Outcomes
•
Before administering any antibiotic be sure to evaluate
the results of the culture and sensitivity test.
•
Take the drug at the prescribed time intervals. These
time intervals are important because a certain amount
of the drug must be in the body at all times for the
infection to be controlled..
•
Always report serious adverse reactions, such as a
severe hypersensitivity reaction, respiratory difficulty,
severe diarrhea, or a decided drop in blood pressure,
to the primary health care provider immediately,
because a serious adverse reaction may require
emergency intervention.
•
Monitor temperature and evaluate the effectiveness of
the treatment via labs and vitals.
•
Neuromuscular blockade or respiratory paralysis may
occur with the administration of aminoglycosides. It is
imperative to monitor respiratory status and report any
respiratory difficulty immediately.
•
To detect ototoxicity, carefully evaluate the patient’s
complaints or comments related to hearing, such as a
ringing or buzzing in the ears.
How do they work? “Action”
The aminoglycosides exert their bactericidal effect
by blocking the ribosome from reading the mRNA,
a step in protein synthesis necessary for bacterial
multiplication.
Indications
•
Infections caused by gram negative organisms
•
Before abdominal surgery to reduce normal flora
in the bowel
Adverse Reactions
•
Nausea
•
Vomiting
•
Anorexia
•
Rash
•
Urticaria
•
Nephrotoxicity
•
Ototoxicity
•
Neurotoxicity
Contraindications & Caution
•
Hypersensitivity
•
Pre existing Hearing loss
•
Myasthenia gravis
•
Parkinsonism
•
Pregnancy & lactation
Interactions:
•
Cephalosporins: Increased risk of nephrotoxicity
•
Loop diuretics (water pills): Increased risk of
ototoxicity
•
Pavulon or Anectine (general anesthetics):
Increased risk of neuromuscular blockade
•
Patient reports comfort without fever.
•
Orientation and mentation remain intact.
•
Patient has adequate renal tissue perfusion.
•
No evidence of injury is seen due to visual or
auditory disturbances.
•
Patient does not experience diarrhea. (Ford 91)
Generic Trade Use Dose
N/A Treatment of serious infections caused
by susceptible strains of microorganisms
3 mg/kg/day in 3 divided doses IM or IV
For life-threatening infection: 5
mg/kg/day in divided doses
Streptomycin N/A
Treatment of serious infections caused
by susceptible strains of microorganisms
PLUS TREATMENT OF TB
15 mg/kg/day IM or 25–30 mg/kg IM 2–3
times per week
Tobramycin N/A
Treatment of serious infections caused
by susceptible strains of microorganisms
3–5 mg/kg/day IM, IV in 3 equal doses
Gentamicin