Name of Drug Classification Mechanism of Action Indication Contraindication Side Effects Nursing Responsibilities

Generic Name: Pharmacologic Class: Penetrates into and disrupts General Indications: Hypersensitivity to CNS: Dizziness, Before
Colistimethate Sodium Polypeptide bacterial cellmembrane, To treat acute or chronic colistimethate or its fever, paresthesia, -Wash hands before administration
resulting in cell death. gram-negativeinfections components, renal disease slurredspeech, ofmedication.
Colistimethate is an inactive caused by Enterobacter tingling -Check the doctor’s order.
Trade/Brand Name: prodrug of thebioactive aerogenes, Escherichia coli, Drug to Drug ofextremities,vertig -Verify pt’s identification.
Coly-Mycin M form colistin. Colistin binds Klebsiellapneumoniae, and Interactions: o -Use colistimethate cautiously in
togram-negative bacterial Pseudomonasaeruginosa aminoglycosides, GI: Nausea, patientswith impaired renal function.
cell membrane vancomycin: Increased pseudomembranous -Caution patient to avoid
Patients’ Dose: Therapeutic Class: phospholipids, increasing riskof developing colitis,vomiting performinghazardous activities,
Antibiotic cell membrane nephrotoxicity GU: Decreased including driving,during
permeability and causing curaniform muscle creatinine clearance colistimethate therapy.
Route: loss of metabolitesessential relaxants, such as and -Explain need for frequent blood
IM injection, IV injection, to bacterial existence. tubocurarine, urine output, testsduring therapy to check kidney
IV infusion, inhalation Patient’s Indication: decamethonium, increased BUN and function.
ether,gallamine, serum -Remind patient that watery
Form: Pregnancy Category: succinylcholine: Potentiated creatinine, orbloody stools can occur 2 or more
Parenteral, capsule C neuromuscular blocking nephrotoxicity monthsafter antibiotic therapy and
effect of thesedrugs sodium MS: Muscle can be serious,requiring prompt
Maximum dose: cephalothin: Possibly weakness treatment.
IM/IV: Pharmacokinetics enhanced RESP: Apnea, - Before givingdrug I.M., make sure
Adult Absorption: Time to peak nephrotoxicity respiratory distress dose is appropriate fordegree of
≤60 kg:75,000 IU/kg/day plasmaconcentration: 2-3 SKIN: Pruritus, renal function.
>60 kg: 6 MIU/24 hr hr(IM). rash, urticaria
Distribution: Widely
INHALATION: distributed, except in CNS During
6 MIU/day and in synovial, pleural, and -Reconstitute each 150-mg vial with
pericardial fluids; crosses 2 mlsterile water for injection to
placenta and enters breast yield75 mg/ml. During
Minimum dose: milk. Plasma protein reconstitution, swirlvial gently to
IM/IV binding: 50%. avoid frothing.
Adult Metabolism: Undergoes -When giving by I.V. injection,
≤60 kg: 50,000 IU/kg/day in hydrolysis to the active slowlyinject half of total daily dose
3 divided doses. substance colistin. over 3 to5 minutes and repeat dose
>60kg: 1-2 MIU tid. Excretion: Mainly via 12 hours later,as ordered.
INHALATION: urine, as unchanged drug. -When giving by I.V.infusion,
1-2 MIU bid or tid Elimination half-life: 2-3 hr. slowly injecthalf of total daily dose
over 3 to 5 minutes.
 ----Then add remaining half of total
dailydose to an appropriate solution,
such asnormal saline solution or
D5W, with typeand amount of
solutiondictated bypatient’s fluid
and electrolyte needs.
-----Starting 1 to 2 hours after first
dose,slowly infuse remaining drug
over 22 to23 hours. If patient has
Availability:
renal impairment,use a reduced
Coly-mycin m 150 mg vial
infusion rate. Oncethe infusion
Colistimethate 150 mg vial
isprepared, use within24 hours.
Coly-Mycin S 3.3-3-10
mg/ml Suspension 5ml
Bottle
After
colistimethate For Injection
-Notify prescriber if patient
150 mg/vial
developsneurologic changes
(paresthesia, tinglingof limbs,
pruritus, vertigo, dizziness,
Content:
slurred speech). Dosage may need to
Colistimethate Sodium
bereduced.
Active Moieties: Colistin
-Monitor patient receiving drug I.M.
becauseapnea and neuromuscular
blockade may
occur with this route, especially in
patientswith impaired renal function.
-Monitor patient’s bowel
elimination. Ifdiarrhea develops,
obtain stool culture tocheck for
pseudomembranous colitis. If
confirmed, expect to stop drug and
givefluid, electrolytes, and
antibiotics effective
against Clostridium difficile.

MIMS.(2020).  MIMS.(2020).  MIMS.(2020).  MIMS.(2020).  MIMS.(2020).  MIMS.(2020).  MIMS.(2020). 

Colistimethate sodium: Colistimethate sodium: Colistimethate sodium: Colistimethate sodium: Colistimethate sodium: Colistimethate Colistimethate sodium:
Indication,Dosage, Side Indication,Dosage, Side Indication,Dosage, Side Indication,Dosage, Side Indication,Dosage, Side sodium: Indication,Dosage, Side Effect,
Effect, Precaution. Effect, Precaution. Effect, Precaution. Effect, Precaution. Effect, Precaution. Indication,Dosage, Precaution. Retrieved 21 March
Retrieved 21 March 2020, Retrieved 21 March 2020, Retrieved 21 March 2020, Retrieved 21 March 2020, Retrieved 21 March 2020, Side Effect, 2020,
 fromhttps://www.mims.com fromhttps://www.mims.com fromhttps://www.mims.com Precaution. fromhttps://www.mims.com/philippi
/philippines/drug/info/colist /philippines/drug/info/colist /philippines/drug/info/colist Retrieved 21 March nes/drug/info/colistimethate
imethate%20sodium/? imethate%20sodium/? imethate%20sodium/? 2020, %20sodium/?
type=brief&mtype=generic. type=brief&mtype=generic. type=brief&mtype=generic. fromhttps://www.m type=brief&mtype=generic.
fromhttps://www.mims.com fromhttps://www.mims.com
ims.com/philippine
/philippines/drug/info/colist /philippines/drug/info/colist
Jones & Bartlett (2015). Jones & Bartlett (2015). Jones & Bartlett (2015). s/drug/info/colistim Jones & Bartlett (2015). Nurses’
imethate%20sodium/? imethate%20sodium/?
Nurses’ Drug Handbook. Nurses’ Drug Handbook. Nurses’ Drug Handbook. ethate%20sodium/? Drug Handbook. 14th Ed.
type=brief&mtype=generic. type=brief&mtype=generic.
14th Ed. Burlington, MA 14th Ed. Burlington, MA 14th Ed. Burlington, MA type=brief&mtype= Burlington, MA
generic.
Jones & Bartlett (2015). Jones & Bartlett (2015).
Nurses’ Drug Handbook. Nurses’ Drug Handbook.
Jones & Bartlett
14th Ed. Burlington, MA 14th Ed. Burlington, MA
(2015). Nurses’
Drug Handbook.
14th Ed. Burlington,
MA