Mindanao State University – Iligan Institute of Technology Student: _________________________ Section:___________
PHARMACOLOGY
DRUG STUDY
Brand Name: Amikacin Sulfate Generic Name: Amikin Drug Classification: Aminoglycoside Antibiotic
Dosage, Route & Frequency Drug-Drug &
Pres Contraindicat Side Effects Adverse Reactions (By
Drug Action Drug-Food Indications
Recommended cribe ions (By System) System)
Interactions
d
Moderate to Severe Infections Adult: Inhibits protein synthesis in bacteria Drug: anesthetics, Primarily for History of Frequent: (≥1%) CNS: neurotoxicity:
IV/IM 5-7.5 mg/kg loading dose, then at the level of the 30S ribosome. skeletal muscle short-term hypersensitivit Phlebitis, Drowsiness, unsteady gait,
7.5mg/kg q12h(max: 15mg/kg/day) for Resists the action of enzymes known relaxants have treatment of y or toxic thrombophlebiti weakness, clumsiness,
7-10 days to inactivate other aminoglycosides. additive serious reaction with s. Occasional: paresthesias, tremors,
Therapeutic Effects: Bactericidal neuromuscular infections or an Rash, fever, convulsions, peripheral
Child: IV/IM 5-7.5 mg/kg loading dose, action against susceptible bacteria. blocking effects; respiratory aminoglycosid urticaria, neuritis. Special Senses:
then 5mg/kg q8h or 7.5 mg/kg q12h for Spectrum: Notable for activity against: acyclovir, tract, bones, e antibiotic; pruritus. Rare: Auditory-ototoxicity, high-
7-10 days (max: 1.5 g/day) Pseudomonas aeruginosa, Klebsiella amphotericin B, joints, skin and lactation Neuromuscular frequency hearing loss,
pneumoniae, Escherichia coli, bacitracin, soft tissues, blockade complete hearing loss
Neonate: IV/IM 10 mg/kg loading dose,
Proteus, Providencia , Enterobacter, capreomycin, CNS (including (difficulty (occasionally permanent);
then 7.5 mg/kg q12h for 7-10 days
Citrobacter freundii, Serratia, cephalosporins, meningitis), breathing, tinnitus, ringing or buzzing
Uncomplicated UTI Acinetobacter, Mycobacterium. colistin, cisplatin, peritonitis drowsiness, in ears; Vestibular:
Adult: IV/IM 250mg q12h Amikacin is also active against carboplatin, burns, weakness). Dizziness, ataxia GI:
Staphylococci(including methicillin- methoxyflurane, recurrent Nausea, vomiting,
Obesity Dosage Adjustment Calculate resistant strains). Acts synergistically polymyxin B, urinary tract hepatotoxicity. Metabolic:
dose based on IBW with beta-lactam anti-infectives vancomycin, infections Hypokalemia,
against gram-negative organisms. In furosemide, (UTIs) hypomagnesemia, Skin:
Renal Impairment Dosage the treatment of enterococcal ethacrynic acid Skin rash, urticaria, pruritis,
Adjustment infections, synergy with a penicillin is increase risk of redness. Urogenital:
CrCl greater than 60mL/min: Normal required. ototoxicity and Oliguria, urinary frequency,
dose q8h; 40-60 mL/min: Normal dose nephrotoxicity hematuria, tubular necrosis,
q12h; 20-39mL/min: Half dose q24h; Pharmacokinetics azotemia. Other:
less than 20mL/min: Administer loading Peak: 30 min IV; 45 min to 2 h IM. Superinfections
dose then monitor closely Distribution: Does not cross blood-
brain barrier; crosses placenta;
accumulates in renal cortex.
Elimination: 94-98% renally in 24h,
Hemodialysis Dosage Adjustment remainder in 10-30 days. Half-Life: 2-
Administer dose post-dialysis or give 3 h in adults. 4-8h in neonates
2/3 dose as supplemental dose
Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment: Assess for infection at beginning and throughout therapy. Assess VS. Monitor Patient/Family Teaching: Instruct patient to report signs of hypersensitivity, tinnitus, vertigo,
intake and output and daily weight. Assess for signs of superinfection. Obtain specimens for muscle weakness/twitching, feeling of fullness in the head, or hearing loss.
culture and sensitivity before initiating therapy. Evaluate eighth cranial nerve function by
audiometry before and throughout therapy. Monitor for vestibular dysfunction such as vertigo, Evaluation/Desired Outcomes: Resolution of the signs and symptoms of infection. If no
ataxia, nausea, vomiting. Amikacin should be discontinued if tinnitus or subjective hearing loss response is seen within 3– 5 days, new cultures should be obtained.
occurs. Monitor renal function by urinalysis, specific gravity, BUN, creatinine, and CCr before
and during therapy. Monitor therapeutic blood levels periodically during therapy. Draw blood
for peak levels 1 hr after IM injection and 30 min after a 30-min IV infusion is completed.
Trough levels should be drawn just before next dose. Peak level range 20– 30 mcg/mL; trough
level 10 mcg/mL. Unlabeled q 24 h dosing—trough level 1 mcg/mL.
Potential Nursing Diagnoses: Risk for infection (Indications) Disturbed sensory perception
(auditory) (Side Effects)
Implementation: Keep patient well hydrated (1500– 2000 mL/day) during therapy. IV: If
aminoglycosides and penicillins or cephalosporins must be administered concurrently,
administer in separate sites, at least 1 hr apart. IV Administration. pH: 3.5– 5.5. Diluent: Dilute
with D5W, D10W, 0.9% NaCl, dextrose/ saline combinations, or LR. Solution may be pale yellow
without decreased potency. Stable for 24 hr at room temperature. Concentration: 10 mg/mL.
Rate: Infuse over 30– 60 min. Heparin is incompatible with syringe and additives are not
recommended for admixing.
