Mount Saint Joseph University

School of Health Sciences, Department of Nursing

514 Gardner/Clephane

MEDICATION ADMINISTRATION SHEET

Generic and Product name of the drug _____Tobramycin Sulfate

Classification & sub-classification (if applicable) of the drug:

AMINOGLYCOSIDEANTIBIOTIC

Normal dose range specific for indication and patient population:

Child:IM/IV5yorolder:22.5

mg/kg/daydividedq4h

PEDS: Safe dose range calculation for your patients weight in Kg (show work)

mg
2mg
22.8kg
________ = _____
______
kg/dose
kg/day
1
mg
2.5mg
________ = _______
kg/dose
kg/day

22.8kg
_______
1

1 day
______
6 dose

= 7.6 mg

1 day
_______ = 9.5 mg
6 dose

Is the ordered dose on MAR safe for patient per dose (yes/no)? YES
Is the ordered dose on MAR safe for patient per daily (24hr) total (yes/no)? YES

Source: Wilson,

B. A., Shannon, M. T., & Shields, K. M. (2015). Pearson nurses drug

guide 2015. Upper Saddle River, NJ: Pearson Education.

1.

What are the patient specific indications and uses

Mount Saint Joseph University

School of Health Sciences, Department of Nursing
of this medication?

514 Gardner/Clephane

Treatmentofsevereinfectionscausedbysusceptible
organisms.Thisisbeingusedforaneyeinfection.

2. What is the action of this medication in the body?

How would you evaluate its effectiveness?

Broadspectrum,aminoglycosideantibioticthatbinds
irreversiblytooneoftwoaminoglycosidebindingsites
onthe30Sribosomalsubunitofthebacteria,thus
inhibitingproteinsynthesis,resultinginbacterialcell
death.

3. What are the major side effects/adverse effects of

this medication?

CNS:Neurotoxicity(includingototoxicity),
nephrotoxicity,increasedAST,ALT,LDH,serum
bilirubin;anemia,fever,rash,pruritus,urticaria,
nausea,vomiting,headache,lethargy,superinfections;
hypersensitivity.SpecialSenses:Burning,stingingof
eyeafterdruginstillation;liditchingandedema.

4. What are the important nursing considerations

related to administering this medication?

BLACK BOX WARNING: obramycinhasbeen

associatedwithototoxicityandnephrotoxicity.Weigh
patientbeforetreatmentforcalculationofdosage.
Observepatientreceivingtobramycincloselybecause
ofthehighpotentialfortoxicity.Monitorauditory,
andvestibularfunctionsclosely,particularlyin
patientswithknownorsuspectedrenalimpairment
andpatientsreceivinghighdoses.Beawarethatdrug
inducedauditorychangesareirreversible(partialor
total);usuallybilateral.Partialorbilateraldeafness
maycontinuetodevelopevenaftertherapy
discontinued.MonitorI&O.

5. Are there any other special considerations

related to administering this medication
based on the patient population? (i.e. if
giving an IM injection to a newborn, what
size needle is needed. If giving a
medication to a pediatric patient, how will
it be given?)

IntramuscularGivedeepIMintoalargemuscle.
Rotateinjectionsites.
IntravenousNote:VerifycorrectIVconcentration
andrateofinfusiontoneonates,infants,orchildren
withprescriber.
PREPARE:IntermittentDiluteeachdosein50100
mLormoreofD5W,NSorD5/NS.Final
concentrationshouldnotexceed1mg/mL.
ADMINISTER:Intermittent:Infusedilutedsolution
over2060min.Avoidrapidinfusion.

Mount Saint Joseph University

School of Health Sciences, Department of Nursing

514 Gardner/Clephane