Aminoglycosides & Spectinomycin Chapter 45 From Katzung 10Th Edition

Front 1

Aminoglycosides used mostly against

Back 1

Gram negative enteric bacteria

Front 2

2 conditions that inhibit transport of aminoglycosides by reducing the gradent

Back 2

Low extracellular pH and anaerobic conditions

Front 3

Synergism of these antibiotics may enhance transport of aminoglycosides into bacteria

Back 3

cell wall-active drugs (ie. penicillin or vancomycin)

Front 4

Mechanism of action of aminoglycosides

Back 4

Protein synthesis inhibition by:
1. Interference of initiation complex of petide formation
2. Misreading of mRNA which cause incorporation of incorrect AAs
3. Breakup of polysomes into nonfunctional monsomes

Front 5

Mechanisms of aminoglycosides resistance

Back 5

1) Direct aminoglycoside modification by a transferase enzyme
2) Impaired entry of the drug into the cell (mutation of porin proteins involved in transport)
3) Mutation of the receptor on the 30S ribsomal subunit

Front 6

Aminoglycosides have a concentration-______ killing

Back 6

Dependent

Front 7

Aminoglycosides have both ____- and _________-dependent toxicity

Back 7

time; concentration

Front 8

Properties of aminoglycosides that requires once-daily dose rather than multiple smaller doses

Back 8

Concentration-dependent killing and postantibiotic effect

Front 9

Reason for intrathecal or intraventricular injection to achieve higher levels of aminoglycocides in CSF (Properties of the molecule)

Back 9

Highly polar compounds that do not enter cells readily

Front 10

Half life of aminoglycosides

Back 10

2-3 hrs

Front 11

Toxic effects of aminoglycosides (all)

Back 11

Ototoxic and Nephrotoxic; Ototoxicity can manifest as auditory damage (tinnitus and high-frequency hearing loss and vestibular damage); Nephrotoxicity can result in rising serum creatinine levels or decreased clearance of creatinine

Front 12

Drug combos to treat enterococcal endocarditis, viridans streptococcal and staphylococcal endocarditis

Back 12

penicillin-aminoglycoside; Penicillin-streptomycin

Front 13

Why can't treat with streptomycin alone?

Back 13

Resistance has emerged in most species

Front 14

Which drug has largely replaced streptomycin?

Back 14

Gentamicin

Front 15

Resistance to gentamicin is definitely also resistant to what 3 other drugs but still susceptible to this drug?

Back 15

Netilmicin, Tobramycin and Amikacin; supseptible to streptomycin

Front 16

Streptomycin is mainly used as a second-line agent for treatment of

Back 16

TB

Front 17

Drug combo for plague, tularemia and sometimes brucellosis

Back 17

Streptomycin (intramuscular) in combo with oral tetracycline

Front 18

Adverse rxns of Streptomycin

Back 18

1) Hypersensitivity in prolonged usage
2) Irreversible vestibular damage (vertigo, loss of balance) = contraindication during pregnancy

Front 19

Gentamicin effective agains both

Back 19

Gram-positive and gram-negative organisms; (staphylococci and coliforms)

Front 20

Gentamicin has synergy with these antibiotics against psudomonas, proteus, enterobacter, klebsiella, serratia, stenotrophomas and other gram-negative rods that may be resistant to multiple other antibiotics

Back 20

beta-Lactams

Front 21

Adverse reactions of Gentimicin

Back 21

Reversible Nephrotoxicity and irreversible ototoxicity

Front 22

In practicality, genticicin is interchangeable with this aminoglycocide

Back 22

Tobramycin

Front 23

More active against pseudomonas (Gentamicin vs Tobramycin)

Back 23

Tobramycin

Front 24

Patient has Lower Respiratory Infection with Pseudomonas aeruginosa complicated with cystic fibrosis, treat with this antibiotics

Back 24

Inhale solution of Tobramycin

Front 25

Treat infection that is resistant to gentamicin and tobramycin with this aminoglycocides

Back 25

Amikacin and netilmicin

Front 26

Treat multidrug-resistant Mycobacterium tuberculosis (including streptomycin-resistance) with this aminoglycocide

Back 26

Amikacin

Front 27

Clinical uses of Neomycin and Kanamycin

Back 27

Topical and oral use for elective bowel surgery; too toxic for parenteral use

Front 28

Neomycin for hepatic coma has been replaced by

Back 28

Lactulose

Front 29

Spectinomycin is used solely as an alternative treatment for drug-resistant _____

Back 29

Gonorrhea or gonorrhea in penicillin-allergic patients

Front 30

Adverse affects of spectinomycin

Back 30

Pain at the injection site and occasionally fever and nausea