Aminoglycosides include - ✔✔ Gentamycin (prototype)(Garamycin)
Amikacin (Amikin)
kanamycin (Kantrex)
neomycin (Mycifradin)
streptomycin (generic
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tobramycin (Tobrex, Tobradex, Nebcin)
Aminoglycosides:
Actions and indications - ✔✔ Bactericidal; inhibit protein synthesis. Effective against gram-negative bacteria. Used for SERIOUS infections when PCN contraindicated. Pseudomonas aeruginosa, E.coli, Proteus, Klebsiella-Enterobacter-Serratia group, Citrobacter and Staph. category D (-cin)
Aminoglycosides: Pharmacokinetics and Route - ✔✔ Poorly absorbed in the GI tract, excreted unchanged in the urine. Usually given IV or IM. Tobradex can be given intra-opthalmic. Neomycin can be given PO.
Aminoglycosides: Contraindications, cautions, adverse effects - ✔✔ Serious side effects: Ototoxicity (risk factors preexisting hearing loss), Nephrotoxicity (risk factors prolonged use, prolonged diuretic use, renal disease) Cardiac dysrhythmias, HTN, hypotension. Contraindicated if myasthenia gravis, Parkinson's, mycobacterial infection, herpes, lactating.
Aminoglycosides: Drug Interactions - ✔✔ Synergistic with PCNs, cephalosporins, carbenicillin or piperacillin. Avoid combining with diuretics. neuromuscular blockade is possible if given with anesthetics, nondepolarizing neuromuscular blockers, succs, or citrate anticoagulated blood.
Aminoglycosides assess - ✔✔ -Contraindications or Cautions
-Baseline physical assessment
-Culture and Sensitivity
-Orientation, Reflex and Auditory Assessment
-Vitals: BP, Respiratory including adventitious breath sounds
-renal and hepatic function tests
Aminoglycosides Interventions: - ✔✔ -Culture and Sensitivity
-full course taken
-monitor infection site and continue drug therapy 2 days after signs and symptoms resolve
-monitor for NEPHROTOXICITY & bone marrow suppression
-safety measures (CNS effects)
-small frequent meals, ice chips or sugarless candy for sore mouth or stomatitis
-fluid replacement with diarrhea
-hydration (prevent renal toxicity)
-Teach:Dosing, Safety (change position slowly, avoid hazardous tasks), fluid intake & nutrition, avoid exposure to other infections, report headache, hearing loss, ringing in ears or changes in urine output
Aminoglycosides Evaluate - ✔✔ -monitor response to drug(free of infection?), adverse effects
-evaluate teaching effectiveness, comfort and safety measures, compliance with regimen
Cephalosporins - ✔✔ Similar to PCNs in structure. Currently 4 generations. Widely used, usually mild side effects and good organism coverage. category B (cef- & -ceph)
1st generation Cephalosporins include - ✔✔ cefalexin (Keflex)
cefazolin (Ancef, Zolicef)
cefadroxil (Duricef)
2nd Generation Cephalosporins include: - ✔✔ cefaclor (Ceclor)
cefoxitin (Mefoxin)
cefprozil (Cefzil)
cefuroxime (Ceftin, Zinacef)
3rd Generation Cephalosporins include: - ✔✔ cefdinir (Omnicef)
cefoperazone (Cefobid)
cefotaxime (Claforan)
cefpodoxime (Vantin)
ceftazidime (Ceptaz, Tazicef)
ceftibuten (Cedax)
ceftriaxone (Rocephin) [Show Less]