Mechanism of

Name of Drug Classification Indication Contraindication Side Effects Nursing Responsibilities

Action
Generic Name: Pharmacologic Penetrates into and General Hypersensitivity to CNS: Dizziness, Before
Colistimethate Sodium Class: disrupts bacterial Indications: colistimethate or its fever, paresthesia, -Wash hands before administration of medication.
Polypeptide cell membrane, To treat acute or components, renal slurred speech, -Check the doctor’s order.
Trade/Brand Name: resulting in cell chronic gram- disease tingling of -Verify pt’s identification.
Coly-Mycin M death. negative Drug to Drug extremities, -Use colistimethate cautiously in patients with impaired
Colistimethate is an infections caused Interactions: vertigo renal function.
Patients’ Dose----------- inactive prodrug of by Enterobacter aminoglycosides, GI: Nausea, - Caution patient to avoid performing hazardous
the bioactive form aerogenes, vancomycin: pseudomembrano activities, including driving, during colistimethate
Route: IM injection, IV colistin. Colistin Escherichia coli, Increased risk of us colitis, therapy.
injection, IV infusion, Therapeutic binds to gram- Klebsiella developing vomiting - Explain need for frequent blood tests during therapy to
inhalation Class: negative bacterial pneumoniae, and nephrotoxicity GU: Decreased check kidney function.
Antibiotic cell membrane Pseudomonas curaniform muscle creatinine - Remind patient that watery or bloody stools can occur
Form: Parenteral, phospholipids, aeruginosa relaxants, such as clearance and 2 or more months after antibiotic therapy and can be
capsule increasing cell tubocurarine, urine output, serious, requiring prompt treatment.
Pregnancy membrane decamethonium, increased BUN - Before giving drug I.M., make sure dose is appropriate
Maximum dose: Category C permeability and ether, gallamine, and serum for degree of renal function.
IM/IV: causing loss of succinylcholine: creatinine,
Adult metabolites Potentiated nephrotoxicity During
≤60 kg: 75,000 essential to Patient’s neuromuscular MS: Muscle -Reconstitute each 150-mg vial with 2 ml sterile water
IU/kg/day bacterial existence. Indication: blocking effect of weakness for injection to yield 75 mg/ml. During reconstitution,
>60 kg: 6 MIU/24 hr --------------------- these drugs sodium RESP: Apnea, swirl vial gently to avoid frothing.
INHALATION: cephalothin: Possibly respiratory -When giving by I.V. injection, slowly inject half of
6 MIU/day enhanced distress total daily dose over 3 to 5 minutes and repeat dose 12
Pharmacokinetics: nephrotoxicity SKIN: Pruritus, hours later, as ordered.
Minimum dose: Absorption: Time rash, urticaria -When giving by I.V. infusion, slowly inject half of total
IM/IV Source: to peak plasma Source: daily dose over 3 to 5 minutes.
Adult MIMS.(2020). concentration: 2-3 MIMS.(2020).  ----Then add remaining half of total daily dose to an
≤60 kg: 50,000  Colistimethate hr (IM). Colistimethate appropriate solution, such as normal saline solution or
IU/kg/day in 3 divided sodium: Distribution: Wide sodium: Source: Source: D5W, with type and amount of solution dictated by
doses. Indication, ly distributed, Indication, MIMS.(2020).  MIMS.(2020).  patient’s fluid and electrolyte needs.
>60kg: 1-2 MIU tid. Dosage, Side except in CNS and Dosage, Colistimethate Colistimethate -----Starting 1 to 2 hours after first dose, slowly infuse
INHALATION: Effect, in synovial, pleural, Side Effect, sodium: Indication, sodium: remaining drug over 22 to 23 hours. If patient has renal
1-2 MIU bid or tid Precaution and pericardial Precaution Dosage, Side Effect, Indication, impairment, use a reduced infusion rate. Once the
Retrieved 21 fluids; crosses Retrieved 21 Precaution. Retrieved Dosage, Side infusion is prepared, use within 24 hours.
March 2020, placenta and enters March 2020, from 21 March 2020, from Effect, Precaution
Availability: from breast milk. Plasma https://www.mims https://www.mims.co Retrieved 21 After
Coly-mycin m 150 mg https://www. protein binding: .com/philippines/ m/philippines/drug/in March 2020, from -Notify prescriber if patient develops neurologic changes
vial mims.com/ 50%. drug/info/colistim fo/colistimethate%2 https://www.mims (paresthesia, tingling of limbs, pruritus, vertigo,
Colistimethate 150 mg philippines/drug/ Metabolism: Unde ethate 0sodium/?type=brief .com/philippines/ dizziness,
vial info/ rgoes hydrolysis to %20sodium/? &mtype=generic. drug/info/colistim slurred speech). Dosage may need to be reduced.
Coly-Mycin S 3.3-3-10 colistimethate%2 the active substance type=brief&mtyp ethate - Monitor patient receiving drug I.M. because apnea and
mg/ml Suspension 5ml 0sodium/? colistin. e=generic. Jones & Bartlett %20sodium/? neuromuscular blockade may
Bottle type=brief Excretion: Mainly (2015). Nurses’ Drug type=brief&mtyp occur with this route, especially in patients with
colistimethate For &mtype=generic via urine, as Jones & Bartlett Handbook. 14th Ed. e=generic. impaired renal function.
Injection 150 mg/vial unchanged drug. (2015). Nurses’ Burlington, MA -Monitor patient’s bowel elimination. If diarrhea
Jones & Bartlett Elimination half- Drug Handbook. Jones & Bartlett develops, obtain stool culture tocheck for
Content: (2015). Nurses’ life: 2-3 hr. 14th Ed. (2015). Nurses’ pseudomembranous colitis. If
Colistimethate Sodium Drug Handbook. Burlington, MA Drug Handbook. confirmed, expect to stop drug and give fluid,
Active Moieties: 14th Ed. Source: 14th Ed. electrolytes, and antibiotics effective
Colistin Burlington, MA MIMS. (2020).  Burlington, MA against Clostridium difficile.
Colistimethate
Source: sodium: Source:
Jones & Bartlett (2015). Indication, Dosage, MIMS.(2020). 
Nurses’ Drug Side Effect, Colistimethate sodium: Indication, Dosage, Side Effect,
Handbook. 14th Ed. Precaution. Precaution. Retrieved 21 March 2020, from
Burlington, MA Retrieved 21 March https://www.mims.com/philippines/drug/info/colistimeth
2020, from ate%20sodium/?type=brief&mtype=generic.
MIMS. https://www.mims.c
(2020). Colistimethate om/philippines/drug Jones & Bartlett (2015). Nurses’ Drug Handbook. 14th
sodium: Indication, /info/colistimethate Ed. Burlington, MA
Dosage, Side Effect, %20sodium/?
Precaution. Retrieved type=brief&mtype=
21 generic.
March 2020, from
https://www.mims.com/ Jones & Bartlett
philippines/drug/info/ (2015). Nurses’
colistimethate%2 Drug Handbook.
0sodium/?type=brief 14th Ed. Burlington,
&mtype=generic. MA