Names and pronunciation
(pla-zoe-mye′sin) Zemdri
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Drug reference
(pla-zoe-mye′sin) Zemdri
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Func. class.: Antiinfective—amino- glycoside
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ACTION: Bactericidal; inhibits bacterial protein synthesis through irreversible binding to the 30S ribosomal subunit of susceptible bacteria
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USES: Complicated urinary tract infection (UTI), including pyelonephritis
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CONTRAINDICATIONS: Aminoglycoside hypersensitivity, pregnancy Precautions: Breastfeeding, colitis, diarrhea, geriatrics, GI disease, hearing impairment, myasthenia gravis, pseudo- membranous colitis, renal disease
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Black Box Warning: Nephrotoxicity, neuro- muscular blockade, ototoxicity, pregnancy Black Box Warning: Increase: nephro- toxicity—cephalosporins, acyclovir, van- comycin, amphotericin B, cyclosporine, loop diuretics, cidofovir Black Box Warning: Increase: ototoxic- ity—IV loop diuretics Black Box Warning: Increase: neuro- muscular blockade, respiratory depres- sion—anesthetics, nondepolarizing neuromuscular blockers Black Box Warning: Nephrotoxicity is greater in those with impaired renal func- tion, the elderly, and in those receiving other nephrotoxic medications; monitor creatinine clearance in all patients before starting therapy and daily; therapeutic drug monitoring (TDM) is recommended for complicated urinary tract infection patients with CCr <90 mL/min to avoid potentially toxic levels; I&O ratio, urinaly- sis daily for casts, protein; report sudden drop in urinary output Black Box Warning: Ototoxicity: hear- ing loss, tinnitus, and/or vertigo; assess hearing baseline and throughout treat- ment; may be irreversible and may not become evident until after completion of therapy; usually in patients with a family history of hearing loss, with renal impair- ment, or in those receiving higher doses and/or longer durations of therapy than recommended P Black Box Warning: Neuromuscular blockade in those with neuromuscu- lar disorders (myasthenia gravis) or in those receiving neuromuscular blocking agents; respiratory paralysis may occur • Pregnancy/breastfeeding: can cause fetal harm when administered to a pregnant woman; do not use in preg- nancy; considered compatible with breastfeeding • For dehydration; provide adequate hy- dration of 1500-2000 mL/day Black Box Warning: Ototoxicity: to re- port hearing loss, ringing, roaring in ears; feeling of fullness in the head • To report headache, dizziness, symptoms of overgrowth of infection, renal impairment, symptoms of neph- rotoxicity • To report redness, swelling at infusion site • To drink plenty of fluids each day • Pregnancy/breastfeeding: to notify health care provider if pregnancy is planned or suspected, or if breastfeeding
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SIDE EFFECTS CNS: Headache CV: Hypo/hypertension GI: Nausea, vomiting, diarrhea GU: Decreased renal function, nephro- toxicity MISC: Ototoxicity
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INTERACTIONS
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DOSAGE AND ROUTES • Adult: IV 15 mg/kg q24hr for 4-7 days
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Available forms: Solution for injection 500 mg/10 mL
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Assess: • Weight before treatment; calculation of dosage is usually based on ideal body weight but may be calculated on actual body weight • Vital signs during infusion; watch for hypotension, change in pulse • IV site for thrombophlebitis (pain, swelling, redness); change site if needed; apply warm compress to discontinued site
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CLINICAL CONSIDERATIONS
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Patient and caregiver information:
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PHARMACOKINETICS Plasma protein binding 20%, not metab- olized, excreted by kidneys
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• Adult: IV 15 mg/kg q24hr for 4-7 days
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