Aminoglycosides

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Aminoglycosides

  1. 1. AMINOGLYCOSIDES MRS.PIYALEE RAKESH NURSING TUTOR
  2. 2. INTRODUCTION <ul><li>Aminoglycosides are any group of bactericidal antibiotics derived from species of streptomyces or micromonosporum bacteria that are effective against aerobic gram negative bacilli and Mycobacterium tuberculosis. </li></ul>
  3. 3. <ul><li>COMPOSITION OF AMINIGLYCOSIDES : </li></ul><ul><li>Amino modified sugars </li></ul><ul><li>ACTION : inhibits protein synthesis in bacteria </li></ul>
  4. 4. DOSAGE & ROUTE <ul><li>Amikacin 15mg/kg q 8 hr IM,IV </li></ul><ul><li>Gentamicin 1mg/kg q 8 hr IM,IV </li></ul><ul><li>Streptomycin : in TBC (adults) 1g/day initially decreased to 1g 2-3 times weekly IM </li></ul><ul><li>Tobramycin 0.75-1.25 mg/kg q 6 hr </li></ul>
  5. 5. INDICATIONS OF AMINOGLYCOSIDES <ul><li>Treatment of serious gram negative bacillary infections and infections caused by staphylococci. </li></ul><ul><li>In the management of active TBC in combination with other agents,eg.streptomycin </li></ul><ul><li>To decrease the no.of ammonia producing bacteria in the gut as part of the management of hepatic encephalopathy. </li></ul>
  6. 6. <ul><li>To treat some forms of infectious diarrhea,eg.kanamycin,neomycin. </li></ul><ul><li>Part of endocarditis prophylaxis,eg.gentamicin IM,IV . </li></ul>
  7. 7. <ul><li>CONTRAINDICATIONS : hypersensitivity to aminoglycosides or bisulfites </li></ul><ul><li>DRUG INTERACTION : </li></ul><ul><li>Inactivated by penicillins and cephalosporins when coadministered to pateints with renal insufficiency. </li></ul><ul><li>Increased incidence of ototoxicity with loop diuretics. </li></ul><ul><li>Increased incidence of nephrotoxicity with other nephrotoxic drugs. </li></ul>
  8. 8. <ul><li>SIDE EFFECTS : nausea,vomiting,urticaria,muscles weakness,rash etc. </li></ul><ul><li>ADVERSE EFFECTS: vertigo,myocarditis,hemolytic anemia,thrombocytopenia,pancytopenia, leukemia,hepatic necrosis,muscle paralysis,anaphylaxis,serum sickness etc. </li></ul><ul><li>TOXICITY : ototoxicity,nephrotoxicity </li></ul>
  9. 9. ROLE OF NURSE <ul><li>ASSESSMENT: </li></ul><ul><li>For infection at starting and throughout the therapy. </li></ul><ul><li>Deafness should be noticed by audiometric,roaring and ringing in ears. </li></ul><ul><li>Vertigo should be assessed before,during and after treatment. </li></ul><ul><li>Monitor intake and output. </li></ul>
  10. 10. <ul><li>Daily weight should be taken to assess hydration status and renal function. </li></ul><ul><li>Assess patient for signs of superinfection. </li></ul><ul><li>Monitor neurologic status. </li></ul><ul><li>IMPLEMENTATION : </li></ul><ul><li>Keep patient hydrated 1500-2000ml/day during therapy. </li></ul><ul><li>IM administrstion should be deep into well developed muscles.Alternate injection site. </li></ul><ul><li>Y-site compatibility and incompatability should be considered. </li></ul>
  11. 11. <ul><li>In case if there is vestibular dysfunction,nausea,vomiting,headache,fever then drug should be discontinued. </li></ul><ul><li>PATIENT/FAMILY TEACHING : </li></ul><ul><li>Instruct patient to report if there is loss of hearing, feeling of fullness in head. </li></ul><ul><li>To report headache, dizziness,renal impairment. </li></ul>
  12. 12. <ul><li>EVALUATION </li></ul><ul><li>Therapeutic response if there is absence of fever,draining wounds .etc </li></ul>

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