Lippincotts Drugs to Know for the NCLEX

gentamicin sulfate (injection)
jen-ta-MYE-sin
Pharmacologic class: Aminoglycoside
INDICATIONS
Serious infections caused by sensitive strains of Pseudomonas aeruginosa, Escherichia coli,
Proteus, Klebsiella, Serratia, or Staphylococcus
ACTION
Inhibits protein synthesis by binding directly to the 30S ribosomal subunit; bactericidal.
ADVERSE REACTIONS
CNS: encephalopathy, seizures, fever, headache, lethargy, confusion, dizziness, numbness, peripheral
neuropathy, vertigo, ataxia, tingling
CV: hypotension
EENT: ototoxicity, tinnitus
GU: nephrotoxicity
Hematologic: agranulocytosis, leukopenia, thrombocytopenia, anemia
Respiratory: apnea
Other: anaphylaxis
NURSING CONSIDERATIONS
Be aware that I.V. loop diuretics such as furosemide may increase ototoxicity.
Obtain specimen for culture and sensitivity tests before giving first dose. Begin therapy while
awaiting results.
Obtain blood for peak level 1 hour after I.M. injection and 30 minutes to 1 hour after I.V. infusion
ends; for trough levels, draw blood just before next dose.
Monitor renal function, including urine output, specific gravity, urinalysis, BUN and creatinine
levels, and creatinine clearance. Report any evidence of declining renal function.
Watch for signs and symptoms of superinfection (especially of upper respiratory tract), such as
continued fever, chills, and increased pulse rate.
PATIENT TEACHING
Instruct patient to promptly report adverse reactions, such as dizziness, vertigo, unsteady gait,
ringing in the ears, hearing loss, numbness, tingling, or muscle twitching.
Encourage patient to drink plenty of fluids.