Master Neomycin Sulfate with Picmonic for Nursing RN

Neomycin sulfate is an aminoglycoside antibiotic that disrupts protein synthesis and causes rapid bacterial death. The bactericidal effect is concentration-dependent, meaning the drug's effectiveness increases with higher concentrations relative to the minimum inhibitory concentration.

Neomycin sulfate is indicated for topical infections and may be applied to the eyes, ears, and skin. Instead of parenteral administration, neomycin sulfate is reserved for topical applications. Because neomycin is more ototoxic and nephrotoxic than other aminoglycosides, it is not administered parenterally.

Neomycin sulfate is indicated for intestinal surgery prophylaxis. The drug reduces ammonia-producing bacteria in the gastrointestinal tract and is useful in hepatic encephalopathy. The medication is administered orally to prevent bacterial infection related to surgical procedures of the intestines.

Hepatic encephalopathy happens when liver dysfunction causes brain dysfunction. It is mostly common in patients with chronic liver diseases. In hepatic encephalopathy, the liver can not remove any toxins that build up in the blood and go to the brain, which can cause motor or mental dysfunctions to occur.

Since aminoglycosides may concentrate within the cells of the ear, ototoxicity is a serious side effect of neomycin sulfate. Hearing impairment is caused by damage to sensory hair cells in the cochlea. High-pitched tinnitus, or ringing in the ears, is the first sign indicating cochlear damage. Damage to sensory hair cells of the vestibular apparatus leads to disruption of balance and manifests as headache, nausea, and dizziness. Since ototoxicity is primarily irreversible, the administration of neomycin sulfate should be stopped if the patient begins experiencing symptoms such as tinnitus or persistent headache.

Since aminoglycosides may injure cells of the proximal renal tubules, nephrotoxicity is a serious side effect of neomycin sulfate. Symptoms of aminoglycoside-induced nephrotoxicity include proteinuria, casts in the urine, diluted urine, and elevated creatinine and blood urea nitrogen (BUN) levels. The risk of renal damage is especially high in elderly patients, patients with pre-existing kidney disease, and patients receiving concurrent administration of nephrotoxic agents.

Patients prescribed neomycin sulfate may develop hypersensitivity reactions. Symptoms include an urticarial rash and pruritus. Patients experiencing symptoms of hypersensitivity reactions should stop taking the medication and consult their healthcare provider.

Oral neomycin sulfate may lead to GI superinfection and intestinal malabsorption syndrome. Superinfections are the result of opportunistic pathogens that infect the body during treatment for another primary infection. Prolonged use of neomycin sulfate may lead to bacterial (e.g., Clostrioides Difficile) or fungal superinfection due to disruption of normal gut flora, allowing overgrowth of opportunistic pathogens.

Aminoglycosides can block neuromuscular junctions by inhibiting the release of acetylcholine at the presynaptic nerve terminal, leading to respiratory paralysis. Because of this, they are contraindicated in patients with myasthenia gravis, as they can exacerbate the condition.

Aminoglycosides are known teratogens and are in the pregnancy category D. Teratogens are agents that cause a defect or malformation in the development of the embryo or fetus. Aminoglycosides are especially associated with causing hearing deficits in fetus.