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THE STICKER! IT IS TO BE STUCK ON THE VARIABLE DOSE SECTION OF THE PRESCRIPTION CHART. Ensure that you have read all the exclusion criteria at the top referring to dosing guidelines where necessary.. Add the above reminder sticker to the front of the drug card.This will prompt nursing staff to refer to the variable dosing section of the prescription chart..
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1. GENTAMICIN PRESCRIBING STICKER TEACHING PACK FOR DOCTORS
3.
Add the above reminder sticker to the front of the drug card.
This will prompt nursing staff to refer to the variable dosing section of the prescription chart.
8. What if the patient has had Gentamicin in the last 24 hours? Step 1 determine exact time dose was given.
9. How do I know whether to give the second dose or await the assay result ? If the pt is <65yrs and stable renal function then the second dose can be given without waiting for an assay result.
If the pt is >65 yrs or abnormal renal function or poor urine output then you need to await the assay result before giving the second dose.
After taking a level, do NOT give more than one dose to any patient with out knowing the assay result.
10. When do I take levels? The sticker indicates the first level by the use of a box around the time dose required and nurse administration boxes on the date it is required.
The first pre-dose level is always pre the second dose. It should be taken at least 18-24 hours after the first dose.
Aim for Pre-dose level (trough level) <1mg/L
If the level is normal and renal function stable then the level should be repeated in 3-4 days
If the level is too high then omit the dose and repeat a level the following day and await the result before giving anymore.
11. What are the deadlines for levels? QMC campus-
Weekdays deadline 4:30pm for same day result
Weekends and bank holidays 10:30am for same day result
City campus-
Weekdays deadline 3:30pm for same day result
Weekends and bank holidays 10:00am for same day result.
If taken after these times the result will not be back till the following day so you will need to decide whether to give the dose or wait and document on sticker.
Best to avoid doing levels on a weekend and do levels on a Friday or Monday, then avoid hospital at night teams having to visit and interpret levels for those who have routinely been on gentamicin for a good few days before the weekend.