Drug Index

Gentamicin

 
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Mechanism :

It inhibits essential protein synthesis in the bacterial cell required for survival. It is used in the treatment of severe gram-negative infections and also has some activity against coagulase positive staphylococci.


Indication :

• Gram negative infections

• It is also used in many creams and ointments for topical application in skin infections and as ophthalmic solution for eye infections.


Contraindications :

Hypersensitivity to gentamicin and myasthenia gravis is a contraindication to its use. Patients should be well hydrated during therapy, and renal function should be monitored. Dose adjustment is required in impaired renal function.


Dosing :

IV:

<8 days of life: 2.5 mg/kg IV/IM every 12 hours.

>8 days-2 months: 2.5 mg/kg IV/IM every 8 hours.

>2 months: 7.5 mg IV/IM once daily.


Adverse Effect :

Vestibular, auditory, nephrotoxicity and neuromuscular blockade.


Interaction :

Vancomycin, Cephalosporin, Cyclosporine, Furosemide, Cisplatin, Amphotericin: Increases chances of ototoxicity and nephrotoxicity.
Non-Depolarising Muscle Relaxants: Enhances effect.
Neostigmine, Pyridostigmine: Antagonises effect.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
30-703–5 mg/kg daily and monitor levels
10-302–3 mg/kg daily and monitor levels
5-102 mg/kg every 48–72 hours according to levels

Dose in Patients undergoing Renal Replacement Therapies
CAPDDialysed. CAPD clearance is about 3 mL/min. Dose as in GFR=5–10 mL/min. Monitor levels
HDDialysed. Dose as in GFR=5– 10 mL/min. Give after dialysis
HDF/High fluxDialysed. Dose as in GFR=5– 10 mL/min. Give after dialysis
CAV/VVHDDialysed. Dose in GFR= 30– 70 mL/min according to severity of infection, and measure levels

Hepatic Dose :

No dosage adjustments are needed.
05/25/2020 08:57:59 Gentamicin
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