Low
NA
$$
Traditional Dosing
1.5-2mg/kg IV q8h
Extended Interval Dosing
5-7mg/kg IV q24h
Use Adjusted Body Weight for obese patients
Recommend dosing per pharmacy
Laboratory
Monitor creatinine at least 2 times/week. Discontinue if any signs of nephro- or ototoxicity.
For traditional dosing: Target Peak 8-10 ug/mL, Trough <1 ug/mL.
For extended interval dosing: Target Trough <1 ug/mL
Note: trough level is 0-60min before a dose (usually pre-4th), and peak is 30-60min after dose infused (usually post-3rd).
In critically ill patients, check peak level after the 1st dose as volume of distribution and renal function may change rapidly.
Clinical
Baseline and periodic hearing and vestibular function (questioning audiologic testingwith prolonged therapy)
Increased nephrotoxicity with: amphotericin B, cyclosporine, cisplatin, NSAIDS, contrast dye, vancomycin.
Increased ototoxicity: furosemide.
Neuromuscular blockade agents - respiratory paralysis.
Formal audiology assessment if planning to use aminoglycoside for >7d or if symptoms develop
Inform patient of risk of ototoxicity to report any symptoms
Antimicrobial class: Aminoglycoside
Pregnancy category: D
Average serum half life: 3 hours
Biliary penetration: Moderate
CSF penetration: Poor
Lung penetration: Therapeutic
Urine penetration: Therapeutic
