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Discussion

Tobramycin

I had to give this to my 19 y/o pt yesterday in his nebulizer.

I checked the box and the orders. Orderes were 2ml per neb. The box is labeled for injection!!

This guy can't talk and has no way to tell us if he has ringing in the ears, etc.

I need to know if this is common? Can the injectable solution be given in a neb treatment?

I looked it up in my davis guide but am still confused.

FYI he does NOT have CF he does have pneumonia LLL.

Thanks!!

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Aminoglycosides are lipid insoluble, which means that they do not cross membranes easily. Inhaled tobramycin probably won't cross the alveolar walls in sufficient quantity to cause toxicity. Actually, the reason tobra is given by inhalation is that it crosses poorly from blood to the lungs, where you want it to be.

A number of drugs labeled for IV administration are given intratracheally during emergency situations when there is no IV access – of course, they are given by this route because they cross the alveoli into the blood, but in general, I suspect that drugs that are buffered and safe to inject into the blood are not going to damage the alveoli.

Ask your pharmacist - that's why s/he gets paid the big bucks.

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