Safe Administration of Tobramycin Injection for a Pediatric Patient with Cystic Fibrosis

QUESTION

The prescriber has ordered the following drug. Complexity Level: Sub Unit Dose Patient’s NameMeghan BradshawSexFemaleAge4 yearsHeight102 cmBodyweight16 kg(35.2 lbs)Body Surface Area0.67m2DiagnosisCystic Fibrosis with Pseudomonas aeruginosa infectionAllergiesNKDA ROUTINELY SCHEDULED MEDICINES Date 30/9/2023 Date 30/9/2023 Medicine (print generic name) Tobramycin Injection Dose 40 mg Route Intravenous Injection Dose Calculation 2.5 mg/kg three times a day, every 8 hours Max Dose 2.5 mg/kg every 8 hours Indication Cystic Fibrosis with Pseudomonas aeruginosa infection Prescriber’s Signature Dr Jones Pharm Administration Times06:00-14:00-22:00 Drug Monograph For Use in safeMedicate Only Medication Name Tobramycin Injection Indication Cystic Fibrosis with Pseudomonas aeruginosa infection Administration Route Intravenous Injection Dose Calculation 2.5 mg/kg three times a day, every 8 hours Maximum Dose 2.5 mg/kg every 8 hours Dispensed Dose 80 mg per 2 mL Special Instructions Administer over 3 minutes. Monitor serum-tobramycin concentration. Tobramycin Injection 80 mg per 2 mL ROUNDING For volumes greater than 1mL, round to tenths. For volumes less than 1mL, round to hundredths. STEP 1ADMINISTER THE CORRECT DOSE/VOLUME OF DRUG Carefully study the information above. Select the most appropriate syringe and measure the correct dose/volume of drug. When you have completed this step, click NEXT to continue.

ANSWER

Safe Administration of Tobramycin Injection for a Pediatric Patient with Cystic Fibrosis

Introduction

Administering medications to pediatric patients requires utmost precision and care. This essay provides a comprehensive guide on the safe administration of Tobramycin Injection to a 4-year-old female patient, Meghan Bradshaw, diagnosed with Cystic Fibrosis and Pseudomonas aeruginosa infection. The prescription involves calculating the dose, selecting the appropriate syringe, and administering the medication via intravenous injection. Additionally, special considerations, including monitoring and rounding, are addressed to ensure the medication’s efficacy and safety.

Dosage Calculation

The prescribed dose of Tobramycin Injection is 2.5 mg/kg, to be administered three times a day, every 8 hours. Meghan’s body weight is 16 kg, and her age is 4 years. To calculate the dose for each administration:
Dose = 2.5 mg/kg x Body Weight (kg)
Dose = 2.5 mg/kg x 16 kg
Dose = 40 mg

Therefore, each administration of Tobramycin Injection should contain 40 mg of the medication.

Maximum Dose

The maximum dose allowed for Meghan is 2.5 mg/kg every 8 hours. Based on her weight and prescribed frequency, this maximum dose remains within the recommended range.

Administration Route

Tobramycin Injection is administered intravenously. It is crucial to ensure the correct route of administration to achieve the desired therapeutic effect.

Dispensed Dose

The dispensed dose of Tobramycin Injection is 80 mg per 2 mL. This concentration allows for accurate dosing and minimizes the risk of errors.

Special Instructions

Administer over 3 minutes: Slow administration helps prevent adverse reactions and ensures patient comfort.
Monitor serum-tobramycin concentration: Regular monitoring is essential to assess the drug’s effectiveness and detect any potential side effects promptly.

Rounding

When calculating the dose/volume of Tobramycin Injection, rounding should be applied as follows:
For volumes greater than 1 mL, round to tenths.
For volumes less than 1 mL, round to hundredths.

Ensuring Safe Administration

Verify the prescription details, including Meghan’s name, age, weight, and diagnosis.
Check for allergies: Ensure that Meghan has no known allergies to the medication.
Calculate the correct dose: Based on the prescribed dosage, calculate the exact amount of Tobramycin Injection required for each administration.
Select the appropriate syringe: Choose a syringe that allows accurate measurement of the dispensed dose, considering rounding guidelines.
Administer intravenously: Follow the recommended route of administration, taking the necessary precautions to ensure the medication is infused slowly over 3 minutes.
Monitor serum-tobramycin concentration: Regularly assess Meghan’s serum-tobramycin levels to ensure therapeutic efficacy and safety.

Conclusion

Administering Tobramycin Injection to pediatric patients like Meghan Bradshaw requires precise calculations, accurate dosing, and adherence to special instructions. Following these guidelines, nurses can ensure the safe and effective administration of the medication, contributing to Meghan’s treatment for Cystic Fibrosis and Pseudomonas aeruginosa infection while minimizing the risk of adverse effects.