Infusion gentamicin

Sawchuk, R. J- and Zaske, D. E., Pharmacokinetics of dosing regimens which utilize multiple intravenous infusions gentamicin in bum patients, J. Pharmacokinet. Bio-pharm., 4(2) 183-195, 1976. 

GU/GI procedures (high-risk, penicillin-allergic patients) - 1 g IV over 1 to 2 hours (children, 20 mg/kg) plus gentamicin 1.5 mg/kg IV or IM for both adult (not to exceed 120 mg) and children. Complete injection or infusion within 30 minutes of starting procedure. 

In dairy cattle given gentamicin by a intramuscular injection, intramammary infusion, or intrauterine infusion, milk was free of detectable residues at 60-84 h posttreatment. However, following repeated treatment over a period of 5 days, depletion of gentamicin residues to a concentration less than or equal to 30 ppb appeared at 228 h posttreatment (12). Therefore, illegal and extralabel use of tlie compound is likely to cause residues in milk. 

Warfarin sodium may be adsorbed to PVC and intravenous infusion sets but may be minimized with glass containers or polyethylene-lined containers. Warfarin sodium is incompatible with solutions of adrenaline hydrochloride, amikacin sulfate, metaraminol tartrate, oxytocin, promazine hydrochloride, tetracycline hydrochloride, aminophylline, bretylium tosylate, ceftazidime, cimetidine hydrochloride, ciprofloxacin lactate, dobutamine hydrochloride, esmolol hydrochloride, gentamicin sulfate, labetalol hydrochloride, metronidazole hydrochloride, and vancomycin hydrochloride.130131... 

It is important to monitor peak and trough plasma levels (see p. 20) of gentamicin, tobramycin, netilmicin, and amikacin to avoid concentrations that cause dose-related toxicities (Figure 31.7). [Note Peak levels are defined as those obtained 1/2 to 1 hour after infusion. Trough levels are obtained immediately before the next dose.] Patient factors, such as old age, previous exposure to aminoglycosides, gender, and liver disease, tend to predispose patients to adverse reactions. The elderly are particularly susceptible to nephrotoxicity and ototoxicity. 

Fig. 2 Influence of i.v. flow rate on the infusion profile of gentamicin. (From Ref...

A 37-year-old Asian man received several antibiotics (including intravenous ceftazidime, gentamicin, merope-nem, metronidazole, and vancomycin) postoperatively. After 3 weeks he was given alatrofloxacin 75 mg in 25 ml of dextrose 5% (1.875 mg/ml) and developed generalized clonus. On rechallenge, infusing at half the initial rate, the seizure recurred. A CT scan of the brain was normal. 

A 47-year-old white woman with end-stage renal disease had had anaphylactoid shock after vancomycin 1 g intravenously infused over 1.5 hours and gentamicin 90 mg 3 years before, despite premedication with diphenhydramine (89). She was treated with doubling doses of vancomycin every 30 minutes for methicillin-resistant S. epidermidis. She had no reaction. 

The most common route of administration of aminoglycosides is intravenous, though aminoglycosides can be given intramuscularly. After an intravenous infusion of an aminoglycoside, the peak serum concentration occurs after 30 minutes. Peak serum concentrations for intramuscular injections occur after 30 to 90 minutes. An intravenous dose of 1.5 mg/kg of gentamicin, tobramycin or netilmicin will result in a peak serum concentration of from 4 to 12 ug/ ml a 7.5 mg/kg dose of amikacin will produce a peak serum concentration of 20 to 35 ug/ml. 

Deziel-Evans LM, Hussey WJ. Possible sulfite sensitivity with gentamicin infusion. DICP Ann Pharmacother 1989 23 1032-1033. 

Gentamicin (Garamycin) Protein-Binding Unknown Half-Life 2 hours IM/IV 1-1.7 mg/kg Infusion every 8 hours... 

The variability associated with drug absorption from the gastrointestinal tract can be overcome by using a parenteral preparation (dosage form). It should preferably be administered either by intravenous infusion or slow intravenous injection to avoid circulatory overload. Intraosseous administration is a useful alternative to intravenous injection of some antimicrobial agents (e.g. sodium ampicillin or amoxycillin, cefotaxime, ceftriaxone, gentamicin or amikacin sulphate) in neonatal foals (Fig. 7.1) (Golenz et al, 1994) and puppies (Lavy et al, 1995). This particularly applies when the neonate is in a state of septic shock and/or dehydration. Total plasma protein concentration is an inaccurate index of hydration status unless monitored (repeatedly measured) and interpreted in conjunction with packed cell volume (PCV). 

Thus the new dose would be gentamicin 160 mg every 18 hours and infused over 1 hour the first dose of the new dosage regimen would be given 18 hours (e.g., the new dosage interval) after the last dose of the old dosage regimen. 

In vitro studies with gentamicin and aminophylline have shown that the delivery of these drugs may be delayed substantially depending on the flow rate and injection site. These observations were confirmed with infusion of chloramphenicol succinate and tobramycin. These studies clearly have demonstrated that the variables of intravenous drug infusion systems (e.g., flow rate. 

Aqueous crystalline penicillin G sodium With gentamicin sulfate - 12-18 million units/24 h IV either continuously or in six equally divided doses 1 mg/kg IM or IV every 8 h 2 2 When obtained 1 h after a 20-30 min IV infusion or IM injection, serum concentration of gentamicin of approximately 3 mcg/mL is desirable trough concentration should be <1 mcg/mL. 

Jenke, D.R. Drug binding by reservoirs in elastomeric infusion devices. Pharm.Res., 1994,11, 984-989 [saline 5% dextrose also cilastatin, fluconazole, foscamet, gentamicin, imipenem, lidocaine, penicillin G, tobramycin, vancomycin]... 

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