Do aminoglycosides have a narrow therapeutic window?
Some, such as the aminoglycosides and vancomycin, have a narrow therapeutic index, and toxicity may be severe and irreversible. Therapeutic drug monitoring may be appropriate for these drugs.
Which drugs have a narrow therapeutic window?
Drugs with a narrow therapeutic index 4 We defined the following drugs to be NTI-drugs: aminoglycosides, ciclosporin, carbamazepine, digoxin, digitoxin, flecainide, lithium, phenytoin, phenobarbital, rifampicin, theophylline and warfarin.
Is gentamicin a broad or narrow spectrum?
The aminoglycosides are broad-spectrum, bactericidal antibiotics that are commonly prescribed for children, primarily for infections caused by Gram-negative pathogens. The aminoglycosides include gentamicin, amikacin, tobramycin, neomycin, and streptomycin.
Does gentamicin require therapeutic drug monitoring?
To achieve optimal gentamicin levels, therapeutic drug monitoring (TDM) is recommended. Monitoring of C min is often performed routinely to prevent toxicity, particularly in patients with decreased renal function.
Is gentamicin narrow therapeutic?
Like other aminoglycosides, gentamicin has a narrow therapeutic index and therapeutic drug monitoring has proven to be beneficial, particularly in vulnerable populations such as the elderly. Moreover, there is substantial pharmacokinetic variability in these patients.
Is gentamicin a narrow spectrum antibiotic?
Gentamicin is bactericidal and is a broad spectrum antibiotic (except against streptococci and anaerobic bacteria). Its mechanism of action involves inhibition of bacterial protein synthesis by binding to 30S ribosomes.
Does gentamicin have a narrow therapeutic index?
Is theophylline a narrow therapeutic index drug?
Theophylline has an extremely narrow therapeutic window. Therefore, Theophylline toxicity occurs when serum theophylline levels surpass the levels in the therapeutic range.
What is a narrow-spectrum antibiotic example?
Examples of narrow-spectrum antibiotics are the older penicillins (penG), the macrolides and vancomycin. Examples of broad-spectrum antibiotics are the aminoglycosides, the 2nd and 3rd generation cephalosporins, the quinolones and some synthetic penicillins.
How is gentamicin metabolized?
Gentamicin is not metabolized in the body but is excreted unchanged in microbiologically active form predominantly via the kidneys. In patients with normal renal function the elimination halflife is about 2 to 3 hours. In neonates elimination rate is reduced due to immature renal function.
Why does gentamicin need to be monitored?
Gentamicin can cause serious dose-related side effects including nephrotoxicity and irreversible hearing loss, so it is important to ensure patients receive the correct dose and are monitored regularly.
Is gentamicin a narrow-spectrum antibiotic?
What is the ideal serum level for gentamicin?
It is widely accepted that serum levels should be monitored closely due to the narrow therapeutic window of gentamicin. However, serum monitoring suggestions differ among drug information databases (Table 3). Ideal peak levels range between 4-6 mcg/mL for a urinary
Is it safe to take gentamicin with deafness?
Patient with a family history of deafness should not be given gentamicin due to risk of irreversible otoxicity even when the drug is within therapeutic range1. Dose recommendations. Gentamicin does not distribute well into fatty tissues therefore should be dosed according to the patient’s ideal body weight (IBW).
When to take post dose gentamicin in sepsis patients?
This may be used in patients with severe sepsis and renal impairment (GFR <60ml/min). In patients receiving ≥ 2 doses, a post dose gentamicin level should be collected 18 – 24 hours after the last dose (i.e a pre-dose level). Subsequent doses can be given when pre-dose level is <1mg/L.
When to take gentamicin if renal function is poor?
When the first dose of gentamicin has been given in the evening or night, the level should be taken by 1500hr the following day if this falls within 18- 24 hour window and sent for analysis immediately. If a patient’s renal function is poor or deteriorates, await assay result and give dose when level <1mg/L.