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Name /bks_53161_deglins_md_disk/paromomycin 02/17/2014 08:49AM Plate # 0-Composite pg 1 # 1 1 Interactions paromomycin (par-oh-moemye-sin) Interactions are listed for systemically absorbed drug Drug-Drug: May enhance possible respiratory paralysis after inhalation anes- Classification Therapeutic: amebicide Pregnancy Category C thetics or neuromuscular blockers.qrisk of ototoxicity with loop diuretics. Mayqthe anticoagulant effects of warfarin. Maypthe absorption of digoxin and methotrexate. Indications Route/Dosage Treatment of acute and chronic intestinal amebiasis. Management of hepatic coma as adjunctive therapy. Intestinal Amebiasis Action Inhibits protein synthesis in bacteria at level of 30S ribosome. Therapeutic Effects: Resolution of amebic infections. Spectrum: Notable for activity against: Entamoeba histolytica , Dientamoeba fragilis, Diphyllobothrium latum, Taenia saginata, Cryptosporidium, Giardia lamblia. Pharmacokinetics Absorption: Minimal to no systemic absorption. Distribution: Unknown. Metabolism and Excretion: 100% excreted in feces. Half-life: Unknown. PO (Adults and Children): 8.33– 11.67 mg/kg 3 times daily with meals for 5– 10 days. Hepatic Coma PO (Adults): 4 g/day in 2– 4 divided doses for 5– 6 days. NURSING IMPLICATIONS Assessment ● Assess patient for infection (vital signs, stool) at beginning of and periodically throughout therapy. ● Hepatic Coma: Monitor neurologic status. Prior to administering oral medica- tion, assess patient’s ability to swallow. TIME/ACTION PROFILE ROUTE ONSET PEAK DURATION PO unknown unknown unknown Contraindications/Precautions Contraindicated in: Hypersensitivity to paromomycin or other aminoglycosides; Potential Nursing Diagnoses Risk for infection (Indications) Deficient knowledge, related to medication regimen (Patient/Family Teaching) Implementation Intestinal obstruction. ● Keep patient well hydrated (1500– 2000 mL/day) during therapy. ● PO: Administer with meals. Use Cautiously in: Renal impairment; Ulcerative bowel lesions; OB, Lactation, Pedi: Safety not established. Patient/Family Teaching Adverse Reactions/Side Effects GI: abdominal cramps, diarrhea, nausea, vomiting. Misc: hypersensitivity reactions. ⫽ Canadian drug name. ⫽ Genetic Implication. ● Instruct patient to take as directed for full course of therapy. Missed doses should be taken as soon as possible if not almost time for next dose; do not double doses. ● Advise patient of the importance of drinking plenty of liquids. ● Caution patient that medication may cause nausea, vomiting, or diarrhea. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued. PDF Page #1 Name /bks_53161_deglins_md_disk/paromomycin 02/17/2014 08:49AM Plate # 0-Composite pg 2 # 2 2 ● Advise patient to notify health care professional if ringing in the ears, hearing im- PDF Page #2 pairment, or dizziness occurs. Evaluation/Desired Outcomes ● Resolution of amebic infection. ● Improved neurologic status in hepatic coma. Why was this drug prescribed for your patient? 䉷 2015 F.A. Davis Company