Nebulised gentamicin

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What is this information about?

This information is about nebulised gentamicin. It explains:

• what it is
• what it is used for
• what side effects it may have
• how long you may need to take it for
• how you should take your nebulised gentamicin
• how you should care for the equipment that you use to take it
• who will check how you are when you are taking it.

Why have I been given this information?

You have been given this information because you have a lung infection caused by bacteria and you have been prescribed nebulised gentamicin to treat it. Reading this information will help you to know what to expect from your treatment and how to use your nebuliser safely. Please keep this information so that you can use it in the future.

What is Gentamicin?

Gentamicin is an antibiotic. You are taking it as a nebulised solution straight into your lungs to try to control bacteria that are growing in your sputum (thick mucus, also called phlegm). This may help to reduce the number of chest infections you get.

A nebulised medicine is a liquid medicine which is turned into a very fine spray which you can breathe in using a nebuliser. A nebuliser is an electric machine that sprays a fine, liquid mist of medicine through a mouthpiece or mask.

Are there any side effects?

As with most medicines nebulised gentamicin can have side effects. Some people may have an allergic type of reaction to taking it. You have had checks to make sure that you do not have a reaction to gentamicin before starting to take it at home.

If you do have any side effects when you are taking gentamicin at home do tell a GP or contact the respiratory nurses.

Side effects can include:

• tinnitus and hearing loss. This is because gentamicin can damage your inner ear. It can be ototoxic (poisonous to the ear).
• harm to your kidneys which mean they do not work as well.

If you need checks to make sure that these do not become a problem for you, your Respiratory Nurse will arrange these for you.

Gentamicin can have other side effects that are less usual. These are listed in the medicines information sheet that comes with the medication. If you have any concerns about side effects do contact the Respiratory Nurses.

Are there any other possible side effects that mean I should get urgent help if I have them?

Yes. If you get a tight chest, wheeze, or find it difficult to breath do:

• take your usual Ventolin (salbutamol) and
• contact your GP urgently

Is taking nebulised gentamicin likely to affect how well any other medicines that I am taking work?

No. Not much gentamicin gets into your bloodstream from your lungs so it should not affect any other medicines that you are taking.

How long will I have to take the nebulised gentamicin antibiotic?

If the antibiotic does not cause side effects, your consultant may want you to take it for at least a year and perhaps even for many years. We may do further tests on your sputum to see if you still have the infection as the gentamicin may not clear it completely.

What should I do before I take my nebulised gentamicin?

Do try to clear the sputum from your lungs before you take your nebulised gentamicin. If you have not been shown how to do this or you are struggling with doing it, do ask your Respiratory Nurse if they can send you to see a respiratory physiotherapist (refer you).

How do I make up my dose of nebulised gentamicin?

Gentamicin solution that you can use in a nebuliser does not come ready mixed. You will need to make up the solution yourself. You make the right dose up using a vial (small tube) of 80mg of gentamicin in 2ml of liquid solution. Usually, these are used when people need to inject gentamicin.

Using gentamicin solution in a nebuliser is an ‘unlicensed’ use. This means it is not officially approved (‘licensed’) for treating your health condition at present, but your consultant feels that it is a safe and effective treatment for you.

To make up your dose you will need:

• 5ml syringe
• sterile needle to draw up medication. Use a blunt needle if possible
• 1ml sterile 0.9% saline solution (from a 5ml vial)
• 1 vial of gentamicin (80mg in 2mls).

How do I take my nebulised gentamicin?

1. Please take 4 puffs of your blue inhaler 10 minutes before you take your gentamicin.
2. If you do not have a blue inhaler at home then please use a 2.5mg nebule of salbutamol before you take your gentamicin. 
3. Use the syringe to draw up 1ml of sterile saline. 
4. Into the same syringe, draw up 2mls of gentamicin. The total amount of liquid in the syringe should be 3mls. 
5. Gently squirt this liquid into the nebuliser chamber. 
6. Attach the nebuliser to the compressor with the tubing and switch on. Hold the nebuliser unit level and breathe normally in and out through the mouthpiece. This will take approximately 5 to 15 minutes. 
7. Vent the air that you have breathed out outside through a tube. We will show you how to do this at an appointment before you have to do it at home. 
8. When you have finished taking your nebuliser dose, take the nebuliser apart and wash the parts in hot soapy water. Rinse the parts and then leave them on kitchen paper to dry.  
9. Put the nebuliser back together again just before you need to use it the next time.   

How should I care for my nebuliser equipment?

• Wash the nebuliser chamber in hot soapy water after you have used it and let it dry before you put it back together.
• Sterilise the nebuliser chamber once a week to kill any germs on it and help prevent infections. Do this by putting all the parts in a saucepan with a few drops of washing up liquid and then boil for ten minutes. Do not include the facemask, green T piece and Tubing. Follow the instructions for sterilising that come with your nebuliser if they are different to this.

Your nebuliser chamber should last for a year if you follow the instructions for cleaning it.

How will I get more supplies of gentamicin vials and saline solution?

Contact the Respiratory Nurses a couple of weeks before your supplies are due to run out. prescription.

Who will check how well my treatment is working and how I am doing?

The consultant who prescribed this treatment will check how well your treatment is working. You will be supported throughout by the respiratory nurses.

Your GP will check your general health and report any adverse reactions (side effects) that you may have.

Who should I contact if I have any further questions after I have read this information?