A Drug Study on
GENTAMICIN
____________
In Partial Fulfillment of the
Requirements on NCM-220 RLE
ELECTIVE 2- OPERATING ROOM NURSING ROTATION
Submitted to:
Monica Aguirre, RN
Clinical Instructor
Submitted By:
Keyna Juliet N. Dizon, St. N
BSN 4G- Group 1
April 7, 2022
Generic Name: Gentamicin
Brand Name: Diogent, Garamycin, Genoptic,
Gentacidin, Genoptic S.O.P., Gentak
Classification: Aminoglycosides antibiotics
Pregnancy Category: C
Mode of Action:
Interferes with protein synthesis in bacterial cell by binding to 30S
ribosomal subunit, thus causing misreading of genetic code; inaccurate peptide
sequence forms in protein chain, thereby causing bacterial death
Therapeutic Effect: Interferes with protein synthesis of susceptible
microorganisms. Bactericidal
Dosage and Route:
Parenteral
Susceptible infections
Adult: For severe infections: 3-5 mg/kg daily in divided doses 8 hourly for
7-10 days, by IM or slow IV inj over 2-3 minutes or IV infusion over no
more than 20-30 minutes. Alternatively, initial dose of 5-7 mg/kg once
daily via IV infusion, then adjust subsequent doses according to serum
gentamicin concentration.
Child: <1 month 4-7 mg/kg daily; ≥1 month 4.5-7.5 mg/kg daily; ≥1 year 3-
6 mg/kg daily. Doses are given as a single or in 2 divided doses.
Topical/Cutaneous
Skin infections
Adult: As 0.1% cream/ointment: Apply gently to cleansed affected area 3-
4 times daily.
Child: Same as adult dose.
Indications:
Treatment of serious gram-negative bacterial infections and infections
caused by staphylococci when penicillin or other fewer toxic drugs are
contraindicated. In combination with other agents in the management of serious
enterococcal infections. Prevention of infective endocarditis.
Contraindications:
Hypersensitivity to gentamicin or other aminoglycosides; most parenteral
products contain bisulfates and should be avoided in patient with known
intolerance;
Pediatrics: products containing benzyl alcohol should be avoided in
neonates.
Side Effects:
Blood and lymphatic system disorders: Anaemia, blood dyscrasias, purpura
Eye disorders: Ocular burning and/or irritation (ophth)
Gastrointestinal disorders: Vomiting, nausea, stomatitis.
Infections and infestations: Antibiotic-associated colitis
Metabolism and nutrition disorders: Rarely, hypomagnesemia
Nervous system disorders: Convulsion.
Renal and urinary disorders: Acute renal failure.
Skin and subcutaneous tissue disorders: Erythema, pruritus (topical), rash
Adverse Effects:
CNS: ataxia, vertigo
EENT: ototoxicity (vestibular and cochlear)
GU: nephrotoxicity
MS: muscle paralysis (high parenteral doses)
Misc: hypersensitivity reactions
Drug Interaction:
● Additive effect with other neurotoxic and/or nephrotoxic drugs including
cephalosporins, methicillin, amphotericin B, ciclosporin, cisplatin, potent diuretics
(e.g. ethacrynic acid, furosemide) and neuromuscular blocking agents (e.g.
succinylcholine, tubocurarine).
● May increase hypothrombinanaemic effect of oral anticoagulants
● May antagonise the effect of neostigmine and pyridostigmine. Increased risk of
hypocalcaemia with bisphosphonates. Increased risk of neuromuscular blockade
with botulinum toxin
● May increase plasma concentration with indomethacin in neonates
● Incompatible with penicillins, cephalosporins, erythromycin, furosemide,
heparins, sodium bicarbonate
Nursing Responsibilities:
1. Perform physical assessment. Assess the site of infection; skin color, lesions;
orientation, reflexes, eighth cranial nerve function; P, BP; R, adventitious
sounds; bowel sounds.
R: This is to provide an established baseline data before administering
medication.
2. Monitor and report balance problems and functional limitations to the physician
and nursing staff, and caution the patient and family/caregivers to guard against
falls and trauma.
R: Gentamicin may result to presence of signs of ototoxicity, ataxia and vertigo
that might affect gait, balance, and other functional activities. The main side
effects of gentamicin are dose related. Harmful side effects are ototoxicity, which
is irreversible, and nephrotoxicity
3. Monitor the patient receiving aminoglycosides for signs of decreased renal
function. Monitor urinalysis, urine output, BUN, serum creatinine, hepatic
function (prior to, during, and after treatment); peak and trough gentamicin
serum concentrations (regularly for systemic treatment).
R: This drug may cause declining urine output and increasing blood urea
nitrogen (BUN), creatinine, and declining glomerular filtration rate (GFR).
4. Monitor signs including pulmonary symptoms (tightness in the throat and chest,
wheezing, cough dyspnea) or skin reactions (rash, pruritus, urticaria). Notify
physician or nursing staff immediately if these reactions occur.
R: These are all manifestation of hypersensitivity reactions that needs immediate
action.
5. Always wash hands thoroughly and disinfect equipment (whirlpools,
electrotherapeutic devices, treatment tables, and so forth).
R: This will help prevent the spread of infection. Employ universal precautions or
isolation procedures as indicated for specific patients.
6. Advise patient to report signs including blood or pus in urine, decreased urine
output, fatigue, and weight gain from fluid retention.
R: These are all signs of nephrotoxicity that needs immediate action.
7. Apply ophthalmic preparations by tilting head back; place medications into
conjunctival sac and close eye; apply light pressure on lacrimal sac for 1 minute.
Cleanse area before applying dermatologic preparations; area may be covered if
necessary.
8. Tell patient to report injection site pain.
R: Swelling and irritation can occur at the site where the needle entered the skin.
This is a reaction to the needle or to the medication that was injected, or it may
be a reaction to both.
9. Ensure adequate hydration of patient before and during therapy.
R: It is concluded that a dehydration state will increase plasma and tissue
Gentamicin accumulation and might increase the risk of renal or ototoxicity.
Rehydration will partially prevent and reverse Gentamicin concentration. Fluid
balance should be closely monitored and dehydration must be corrected prior to
commencing treatment. Blood serum levels should be measured frequently,
especially in patients with renal impairment and the elderly. These should not be
taken from the line being used for drug administration.
10. When using topical applications: Avoid excessive exposure to sunlight because
of danger of photosensitivity; withhold medication and notify physician if
condition fails to improve within 1 wk, worsens, or signs of irritation or sensitivity
occur; and apply medication as directed and only for length of time prescribed
(overuse can result in superinfections).
R: Aside from the fact that Gentamicin has photosensitivity reactions,
Ophthalmic gentamicin may cause transient blurring of vision. Instruct the patient
to avoid driving or operate machinery.
11. Do not breast feed while taking this drug without consulting physician.
R: The antibiotic called gentamicin is used to treat infections caused by bacteria.
Small amounts of this medicine pass into breast milk, but it is not thought to be
harmful to nursing babies. New mothers, however, should avoid breastfeeding
when taking this drug.
REFERENCES:
2018 Nurse’s Drug Handbook, Seventeenth Edition. Burlington, MA: Jones & Bartlett
Learning, LLC, an Ascend Learning Company
April Hazard Vallerand & Cynthia A. Sanoski (2019). Davis’s Drug Guide for Nurses
Sixteenth Edition. Philadelphia, PA: F. A. Davis Company.
GENTAMICIN (n.d.). Retrieved from www.robholland.com
Linda Skidmore-Roth (2016). Mosby’s Drug Guide for Nursing Students, Eleventh
Edition. St. Louis, MI: Mosby, an imprint of Elsevier Inc.
Robert J. Kizior & Keith J. Hodgson (2019). Saunders Nursing Drug Handbook 2019.
St. Louis, Missouri. Elsevier Inc
