Bladder Instillation - To Mix Gentamicin Bladder Instillation at home weekly.
Mix three (3) vials of gentamicin (80mg/2ml) into 500ml of normal saline. Follow the steps below.
1. Remove the cap from 3 of the gentamicin vials.
2. Rub the top of vials with an alcohol wipe.
3. Attach the covered needle to the 10ml syringe. Once attached, loosen the cap and pull the syringe plunger back to the 2 mL mark.
4. Uncap the needle and insert straight into the rubber circle on top of the medicine vial. Push the 2 mL of air in. Be careful not to touch the top of the vial with your hands after wiping it with alcohol.
5. Grab the bottle and syringe in one hand to flip vial upside down. Pull the syringe and needle until the needle is in the fluid and not in the air portion of the vial.
6. Draw back 2 mL of medicine, then take the needle out of the vial. Aim the needle into the normal saline bottle without letting the needle touch anything.
7. Push the fluid into the normal saline, and repeat until all 3 of the vials have been drawn up and placed into the normal saline.
8. When 6 mL (or all 3 vials) have been put into the normal saline bottle, cap it and invert the bottle 4-5 times to mix.
9. Discard the needle and syringe into the Sharps container provided by your pharmacy. When the Sharps container is full, close and seal it. Return it to the pharmacy for a new one.
10. Label the bottle with the date one week from the date you mixed it up. Place the bottle in the refrigerator for one week. Do not leave it out at room temperature. Discard after 1 week.
11. After adding gentamicin into the normal saline: the mixture is now 240 mg of gentamicin and 500ml of normal saline.
Instructions for Use
1. Invert bottle of medicine 4-5 times to mix well.
2. Pour about 30 mL into the specimen cup.
3. Using the 60 mL catheter or piston tip syringe, draw up 20 mL of the gentamicin mixture into the syringe. Set the syringe aside on a clean surface. Do not allow the tip of the syringe to touch the counters or other surfaces.
4. For clean intermittent catheter patients, catheterize your bladder as you’ve been taught, until it is empty. Leave the catheter in place.
If you have an indwelling catheter, leave the catheter in place. Detach the bag from the catheter and follow the directions below.
5. For clean intermittent catheter patients: Firmly insert syringe into the end of your catheter. Instill the syringe of gentamicin solution until empty. Withdraw the catheter while the syringe is still attached to the end of the catheter.
For indwelling catheters: Firmly insert the syringe into the end of your catheter. Instill the syringe of gentamicin mixture until empty. Pull the syringe from the catheter. Use a clamp or catheter plug to keep the solution from coming back out of the catheter.
6. Allow the gentamicin mixture to remain in your bladder until the next time you catheterize. It should remain in your bladder for about 1-2 hours. Unclamp the catheter after this time for indwelling catheters.
7. After you’re done with the procedure, wash the items with hot soapy water, rinse well, and air-dry on a clean surface.
8. Throw away any unused medicine mixture after 1 week.
9. Repeat this process as ordered by your doctor: 2 times daily.
10. If you have any problems or questions please call the Urology Nurse at 608-263-6420. You may also call to set up a visit with the nurse to learn how to make this mixture and do the instillation.
Monthly Supplies Needed
Instill the bladder with a gentamicin solution 2 times a day. Patient will mix weekly at home or pick up one bottle per week pre mixed by a local pharmacy. [Gentamicin 3 vials of 80mg/2ml into 500ml of normal saline]. Patient has been given directions for use at home from our clinic.
Please provide patient with the following supplies if they wish to mix the medicine at home.
If patient chooses to pick up at local pharmacy weekly please provide patient with the items in bold/italic.
- Two (2) 60ml piston syringes/catheter tip (change every 2 weeks)
- Four (4) specimen containers (100ml size) to pour medicine mixture into and draw out of. (1 per week)
- Four (4) 10ml syringes/leur lock (1 syringe per week)
- Four (4) 18 gauge needles (1 per week)
- Four (4) alcohol wipes (1 per week)
- Small sharps container
- Twelve (12) vials of gentamicin 80mg/2ml (per month)
- Four (4) 500ml of normal saline bottles (per month)
- Refills #11
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The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 07/23/2009
Copyright © 04/01/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6772
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