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Discussion

Gentamycin question

please advise! I work at an out pt. endoscopy center. Occasionally we give IV Amp and Gent pre op for people with Heart valve replacements. . We give the Gentamycin 80 mg IV push. One of the anesthesiologists freaked and said "that has to be Piggy-backed!!" Slow drip. But we were all taught to give it IVP. I know, HOW STUPID of us never to check. So, how does one give it? We cannot get a straight answer anywhere!!!

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Where I work we give that IV push. We have a policy and procedure manual that says this is appropriate. Our IV drug handbook given to us by pharmacy also says this is appropriate. That is for multiple daily dosing. You can piggyback it also.

The place where I work we are taught to give Gent. IV piggyback because gentamycin is extremely nephrotoxic too much too quick can cause acute renal failure.

I wouldn't be surprised if my hospital was extremely out of date with stuff. I haven't had anyone go into renal failure though (not yet anyway yikes). Let me see of I can find some literature on it.

wE PIGGY BACK IT.........i VE SEEN OTHER GIVEN IVP, BUT NEVER GENTAMICIN.....

Straight out of Davis Drug Guide.....

Gentamicin

* Intermittent Infusion: Dilute each dose in 50-200 ml of D5W, 0.9% NaCl, or LR to provide a concentration not to exceed 1 mg/ml. Also available in commercially mixed piggyback injections. Do not use solutions that are discolored or that contain a precipitate.

* Rate: Infuse slowly over 30 min-2 hr. For pediatric patients, the volume of diluent may be reduced but should be sufficient to permit infusion over 30 min-2 hr.

So now what is your facility up to date or out of date with practice, If so maybe you should do an inservice so everyone will be up-to-date.

I've always given gent via piggyback...at least over 30min. B/C of the nephrotoxicity issue.

Gent is extremely nephro and oto toxic.....many believe that the ototoxicity is limited to peds and neonates, but that's not universally true. Looks like it's time to update the policy!

Jamie

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