Trade Names:Gentamicin- Ointment 0.3% (ophthalmic)- Solution 0.3% (ophthalmic)- Ointment 0.1% (topical)- Cream 0.1% (topical)- Injection 10 mg/mL (as sulfate)- Injection 40 mg/mL (as sulfate)
Trade Names:Gentamicin Sulfate in sodium chloride 0.9%- Injection 0.6 mg/mL (as base)- Injection 0.8 mg/mL (as base)- Injection 0.9 mg/mL (as base)- Injection 1 mg/mL (as base)- Injection 1.2 mg/mL (as base)- Injection 1.4 mg/mL (as base)- Injection 1.6 mg/mL (as base)- Injection 2 mg/mL (as base)
Trade Names:Gentak- Solution 0.3% (ophthalmic)- Ointment 0.3% (ophthalmic)
Trade Names:Gentasol- Solution 0.3% (ophthalmic)Garamycin Topical Preparations (Canada)ratio-Gentamicin (Canada)
Inhibits production of bacterial protein, causing bacterial cell death.
C max is 4 to 8 mcg/mL (IV). T max is 1 h (IM). Oral absorption is poor.
Vd is 0.2 to 0.4 L/kg. Protein binding is 0% to 10%. The half-life is 5 to 15 min. Distributed to extracellular ascitic, pericardial, pleural, synovial, lymphatic, and peritoneal fluids; body tissues; high concentrations in urine; low concentrations in breast milk, line spread function, and sputum. Crosses the placenta but does not cross the blood-brain barrier.
Half-life is 2 h. Peritoneal dialysis is 25% removed in 48 to 72 h. Primary route is renal-glomerular filtration; 50% is removed during a 4 to 6 h hemodialysis period.
End-stage renal disease: half-life is 24 to 60 h.Children
In infants younger than 1 wk old and less than 1,500 g, Vd is up to 0.68 L/kg; more than 1,500 g, Vd is up to 0.58 L/kg. Half-life is 5 to 8 h.
Short-term treatment of serious infections caused by susceptible strains of microorganisms, especially gram-negative bacteria; adjunct to systemic gentamicin in serious CNS infections (injection); treatment of superficial ocular infections (ophthalmic); treatment of primary (eg, impetigo contagiosa) and secondary (eg, infectious eczemafoid dermatitis) skin infections; skin cysts and superficial skin infections, infection prophylaxis, and aid to healing (topical).
Long-term therapy (injection); epithelial herpes simplex keratitis, vaccinia, varicella, mycobacterial infections, fungal diseases (ophthalmic); hypersensitivity to aminoglycosides.
IM/IV 3 to 5 mg/kg/day in divided doses. For obese patients, base dose on estimate of lean body weight.Children
IM/IV 6 to 7.5 mg/kg/day (2 to 2.5 mg/kg every 8 h).Infants and Newborns
IM/IV 7.5 mg/kg/day (2.5 mg/kg every 8 h).Premature or Term Newborns (younger than 1 wk of age)
IM/IV 5 mg/kg/day (2.5 mg/kg every 12 h) or 2.5 mg/kg every 18 h or 3 mg/kg every 24 h.Prevention of Bacterial EndocarditisAdults
IM/IV 1.5 mg/kg with ampicillin 30 min before procedure (max, 80 mg).Children
IM/IV 2 mg/kg with ampicillin 30 min before procedure.Superficial Skin InfectionsAdults and Children
Topical Apply 3 to 4 times daily to infected area.Ocular InfectionsAdults and Children
Topical Apply 0.5-inch ribbon of ointment in each eye 2 or 3 times daily or 1 to 2 drops 4 to 6 times/day.
Store at 59° to 86°F.
May increase risk of nephrotoxicity.Loop diuretics
May increase risk of auditory toxicity.Neuromuscular blocking agents
May enhance effects of these agents.Polypeptide antibiotics
May increase risk of respiratory paralysis and renal function impairment.
Do not mix beta-lactam antibiotics (eg, penicillins, especially ticarcillin and carbenicillin, cephalosporins) in IV solutions.
None well documented.
Headache; dizziness; vertigo; encephalopathy; confusion; fever; lethargy; convulsions; muscle weakness and twitching; peripheral neuropathy; acute organic brain syndrome; depression; pseudotumor cerebri; increased CSF protein; arachnoiditis or burning at injection site after intrathecal administration.
Rash; urticaria; itching; anaphylaxis; photosensitivity (topical).
Blurred vision; tinnitus; hearing loss; mydriasis and conjunctival paresthesia (ophthalmic).
Oliguria; proteinuria; increased serum creatinine and BUN; casts; Fanconi-like syndrome.
Anemia; eosinophilia; leukopenia; thrombocytopenia; granulocytopenia.
Elevated LFT results.
Apnea; pulmonary fibrosis.
Pain and irritation at injection site; splenomegaly; hypomagnesemia; hyponatremia; hypocalcemia; hypokalemia.
Manifests as both auditory and vestibular ototoxicity, and primarily occurs in patients with pre-existing renal damage or in healthy renal function with prolonged therapy. Partial or total irreversible deafness may continue to develop after drug is stopped. Other features of neurotoxicity include paresthesias, twitching, and seizures.Nephrotoxicity
Closely monitor renal and eighth nerve function in patients with suspected renal function impairment. Monitor peak and trough concentrations. Dosage adjustments required in renal function impairment.
Category D (injection). Category C (ophthalmic and topical).
Small amounts excreted into the breastmilk.
Use cautiously in premature infants and newborns because of renal immaturity.
Drug levels and renal function must be monitored closely.
Treatment with antibiotics occasionally allows overgrowth of nonsusceptible organisms, including fungi.
Some products contain sulfites. Do not use if there is history of hypersensitivity.
Pharmacokinetics may be altered; serum levels must be closely monitored for dosing.
Occurs often, especially in those with restricted diets or poor nutrition.
Potential curare-like effects may aggravate muscle weakness or cause neurotoxicity. Use with caution with anesthesia or muscle relaxants; in patients with neuromuscular disorders, hypomagnesemia, hypocalcemia, and hypokalemia; and in newborns whose mothers received magnesium sulfate.
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