- Body system
- Anti-infectives
- Name stem
- -micin, -mycin
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Tobramycin, Amikacin, Streptomycin, Neomycin.
How aminoglycosides work
Bind the 30S ribosomal subunit and cause faulty protein synthesis (bactericidal).
Uses
- Serious gram-negative infections
- Synergy for endocarditis
- Inhaled tobramycin in cystic fibrosis
- Bowel preparation and hepatic encephalopathy (oral neomycin)
Adverse effects
- Nephrotoxicity
- Ototoxicity (cochlear and vestibular)
- Neuromuscular blockade and respiratory paralysis
Nursing considerations
- Monitor peak and trough levels, creatinine, urine output and hearing.
- Avoid other nephrotoxic and ototoxic drugs when possible (loop diuretics, vancomycin, NSAIDs, contrast).
- Hydrate well.
Patient teaching
- Report ringing in the ears, hearing loss or dizziness.
- Drink fluids unless restricted.
Aminoglycosides NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which finding should be reported immediately in a patient receiving gentamicin?
Show answer
Answer A: Tinnitus Ringing in the ears can signal ototoxicity, which can become permanent.
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A trough level is high in a patient receiving gentamicin. Which risk is increased?
Show answer
Answer A: Nephrotoxicity and ototoxicity High troughs mean the drug is not clearing between doses, which raises the risk of kidney and ear toxicity.
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Which drug, given with gentamicin, increases the risk of ototoxicity?
Show answer
Answer C: Furosemide Loop diuretics are also ototoxic; the combination increases the risk.
Frequently asked questions
What are aminoglycosides?
Aminoglycosides are potent gram-negative antibiotics with two major toxicities: kidney damage and hearing or balance damage. Peak and trough levels guide safe dosing.
How do aminoglycosides work?
Bind the 30S ribosomal subunit and cause faulty protein synthesis (bactericidal).
What are examples of aminoglycosides?
Gentamicin, Tobramycin, Amikacin, Streptomycin and Neomycin.
What are the nursing considerations for aminoglycosides?
Monitor peak and trough levels, creatinine, urine output and hearing. Avoid other nephrotoxic and ototoxic drugs when possible (loop diuretics, vancomycin, NSAIDs, contrast).