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ALL / Pharmacology

Gentamicin

Gentamicin

Gentamicin is a type of aminoglycoside antibiotic. It is poorly lipid-soluble and is therefore given parentally (e.g. for infective endocarditis) or topically (e.g. for otitis externa).

Adverse effects
  • ototoxicity
    • due to auditory or vestibular nerve damage
    • irreversible
  • nephrotoxicity
    • accumulates in renal failure
    • gentamicin is preferentially taken up by the proximal renal tubular cells. Once inside these cells, it can accumulate to toxic levels
    • the toxicity is secondary to acute tubular necrosis
    • concomitant use of furosemide increases the risk
    • lower doses and more frequent monitoring is required

Contraindications
  • myasthenia gravis

Dosing
  • due to the significant ototoxic and nephrotoxic potential of gentamicin it is important to monitor plasma concentrations
  • both peak (1 hour after administration) and trough levels (just before the next dose) are measured
  • if the trough (pre-dose) level is high the interval between the doses should be increased
  • if the peak (post-dose) level is high the dose should be decreased
+PassMedicine Notes

Gentamicin is a type of aminoglycoside antibiotic. It is poorly lipid-soluble and is therefore given parentally (e.g. for infective endocarditis) or topically (e.g. for otitis externa).

Adverse effects
  • ototoxicity
    • due to auditory or vestibular nerve damage
    • irreversible
  • nephrotoxicity
    • accumulates in renal failure
    • gentamicin is preferentially taken up by the proximal renal tubular cells. Once inside these cells, it can accumulate to toxic levels
    • the toxicity is secondary to acute tubular necrosis
    • concomitant use of furosemide increases the risk
    • lower doses and more frequent monitoring is required
Contraindications
  • myasthenia gravis
Dosing
  • due to the significant ototoxic and nephrotoxic potential of gentamicin it is important to monitor plasma concentrations
  • both peak (1 hour after administration) and trough levels (just before the next dose) are measured
  • if the trough (pre-dose) level is high the interval between the doses should be increased
  • if the peak (post-dose) level is high the dose should be decreased


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