Amikacin

Name of Drug

Generic Name: Amikacin
Brand Name: Amikin
Route / Dosage: IM, IV (Neonates): Loading dose –10 mg/kg;Maintenance dose—7.5 mg/kg q 12 hr.

Classification

Therapeutic: Anti - Infectives
Pharmacologic: Aminoglycosides
Pregnancy Category D

Mode of Action

Inhibits protein synthesis in bacteria at level of 30S ribosome.
Therapeutic Effects: Bactericidal action.
Spectrum: Most aminoglycosides notable for activity against P. aeruginosa, Klebsiella pneumoniae, E. coli, Proteus, Serratia, Acinetobacter, Staphylococcus aureus. In treatment of enterococcal infections, synergy with a penicillin is required.

Indication

Treatment of serious gram-negative bacillary infections and infections caused by staphylococci when penicillins or other less toxic drugs are contraindicated.
Unlabeled Uses: In combination with other agents in the management ofMycobacterium avium complex infections.

Contraindications

Contraindicated in: Hypersensitivity to aminoglycosides. Most parenteral products contains bisulfides and should be avoided in patients with known tolerance. Products containing benzyl alcohol should be avoided in neonates.
Use Cautiously in: Renal impairment (dose adjustments necessary; blood level monitoring useful in preventing ototoxicity and nephrotoxicity); Hearing impairment; Neuromuscular diseases such as myasthenia gravis; Obese patients(dose should be based on ideal body weight); Pedi: Neonates have increased risk o fneuromuscular blockade; cautious use due to difficulty in assessing auditory and vestibular function and immature renal function; Geri: Cautious use in geriatric patients due to difficulty in assessing auditory and vestibular function and age-related renal impairment.

Side / Adverse Effects

CNS: ataxia, vertigo. EENT: ototoxicity (vestibular and cochlear). GU: nephrotoxicity. F and E: hypomagnesemia. MS: muscle paralysis (high parenteral doses). Neuro: increase neuromuscular blockade. Resp: apnea. Misc: hypersensitivity reactions.

Nursing Responsibilities

  • Assess patient for signs and symptoms of infection prior to and throughout therapy.
  • Instruct patient to continue taking medication around the clock until finished completely, even if feeling better.
  • Keep patient hydrated during therapy.
  • Instruct patient to report signs of hypersensitivity.
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