Kanamycin Sulfate

A to Z Drug Facts

Kanamycin Sulfate

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(kan-uh-MY-sin SULL-fate)

Kantrex

Class: Antibiotic/aminoglycoside

Action Inhibits production of bacterial protein, causing cell death.

Indications

Parenteral: Short-term treatment of serious infections caused by susceptible strains of microorganisms, especially gram-negative bacteria. Oral: Short-term adjunctive therapy for suppression of intestinal bacteria; treatment of hepatic coma.

Contraindications Hypersensitivity to aminoglycosides; intestinal obstruction (oral). Generally not indicated for long-term therapy (> 14 days) because of ototoxicity and nephrotoxicity.

Route/Dosage

Infection

ADULTS & CHILDREN: IM/IV 15 mg/kg/day in 2–4 divided doses. Do not exceed 1.5 g/day.

Suppression of Intestinal Bacteria

Adults: PO 1 g qh for 4 hr, then 1 g q 6 hr for 36–72 hr.

Hepatic Coma

Adults: PO 8–12 g/day in divided doses.

Interactions

Digoxin, methotrexate, vitamin A, vitamin K: Oral kanamycin may decrease absorption of these drugs. Beta-lactam antibiotics (eg, cephalosporins, penicillins): Do not mix in IV solutions. Drugs with nephrotoxic potential (eg, amphotericin, cephalosporins, enflurane, methoxyflurane, vancomycin): Increased risk of nephrotoxicity. Loop diuretics: Increased auditory toxicity. Neuromuscular blocking agents: Enhanced effects of these agents. Polypeptide antibiotics: Increased risk of respiratory paralysis and renal dysfunction.

Lab Test Interferences None well documented.

Adverse Reactions

CNS: Neuromuscular blockade. EENT: Hearing loss, deafness, loss of balance. GI: Malabsorption syndrome (eg, increased fecal fat, decreased serum carotene, fall in xylose absorption), nausea, vomiting, diarrhea. GU: Oliguria, proteinuria, elevated serum creatinine and BUN, granular casts, red and white cells in urine, decreased creatinine clearance. RESP: Apnea. OTHER: Pain and irritation at injection site, acute muscular paralysis; hypomagnesemia.

Precautions

Pregnancy: Category D. Lactation: Excreted in breast milk. Children: Use cautiously in premature infants and neonates because of renal immaturity. Neuromuscular blockade: Use with caution in patients with neuromuscular disorders, those receiving anesthesia or muscle relaxants, hypomagnesemia, hypocalcemia, hypokalemia or in neonates whose mothers received magnesium sulfate. Oral absorption: Increased absorption (and potential for toxicity) when intestinal mucosa is ulcerated or denuded. Toxicity: Can cause ototoxicity, both auditory and vestibular. Nephrotoxicity may occur; greater risk factors in the elderly, patients with renal impairment, high or frequent doses, long duration of therapy, other nephrotoxic drugs, potassium depletion and decreased intravascular volume.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Do not mix with other antibacterial agents; administer separately.
For IV administration, dilute each 500 mg with at least 100–200 ml of 0.9% Sodium Chloride or D5W. Give slowly over 30–60 min.
Give IM injection deeply into upper outer quadrant of gluteal muscle.
Store at room temperature. Darkening of vials during shelf life does not indicate loss of potency.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies. Note hypersensitivity to aminoglycosides.
Ensure that culture and sensitivity, renal function tests and serum electrolytes have been performed before beginning therapy and repeat periodically.
Assess for superinfection (bacterial or fungal overgrowth).
Assess for allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in susceptible persons (more frequent in asthmatic or atopic nonasthmatic persons).
Keep patient well hydrated (especially important in elderly).
Assess auditory function regularly.
Monitor drug serum concentrations periodically.
Monitor I&O.

OVERDOSAGE: SIGNS & SYMPTOMS
	Nephrotoxicity, auditory toxicity, vestibular toxicity, neuromuscular blockade, respiratory paralysis

Patient/Family Education

Advise patient that drug may cause nausea, vomiting or diarrhea.
Instruct patient to drink plenty of fluids while taking medication.
Emphasize importance of follow-up visits and serial audiograms, because ototoxicity may be asymptomatic.
Instruct patient to report these symptoms to physician: ringing in ears, hearing impairment, rash, difficulty urinating or dizziness.