Aminoglycosides (Gentamicin, Tobramycin) on the NCLEX
Aminoglycoside class: ototoxicity, nephrotoxicity, peak/trough monitoring.
Aminoglycosides (gentamicin, tobramycin, amikacin) are powerful for serious gram-negative infections. The NCLEX hammers oto- and nephrotoxicity.
Common drugs
Gentamicin, tobramycin, amikacin, streptomycin (TB), neomycin (oral, not systemic).
Toxicities
Ototoxicity, irreversible. Monitor for tinnitus, hearing changes. Nephrotoxicity, monitor BUN/creatinine. Neuromuscular blockade, caution with neuromuscular disease.
Peak / trough
Trough drawn 30 min before dose. Peak 30 min after IV infusion ends. Adjust dose to keep trough low (avoid toxicity) and peak therapeutic. Once-daily dosing reduces toxicity in most settings.
Synergy
Often combined with beta-lactams (e.g., gentamicin + ampicillin) for enterococcal endocarditis.
Frequently asked
Why monitor trough not just peak?
High trough correlates with toxicity. Therapeutic peak ensures efficacy.
Once-daily dosing?
Higher peak, longer interval between doses. Allows kidney recovery. Standard in most settings.
Quick check
Loading a question…
How ready are you right now?
10 real NCLEX questions, free, in your browser. See how close you are to ready and which subjects are costing you.
Try 10 questions free