Br Pharmacology: Aminoglycosides

Front 1

Traditionally antibiotics have been designed to maintain serum MIC for as long as possible. How are aminoglycosides different? Compare to penicillins and cephlosporins?

Back 1

1) have a concentration dependent killing action
a. meaning they killing faster and more organisms above the MIC
2) time-dependent killing of bacteria
a. there efficacy is directly related to time above MIC and becomes independent of concentration once MIC has been reached

Front 2

To achieve the greatest efficacy how should aminoglycosides be administered?

Back 2

1) single large dose because killing actions continue when plasma levels have declined and work better at higher concentrations
2) intramuscularly or IV

Front 3

Are aminoglycosides cidal or static? What is there uptake into host dependent on? As a result they are not effective against which bacteria?

Back 3

1) bactericidal
2) oxygen-dependent transport
3) little activity against strict anearobes

Front 4

What can aminoglycoside uptake be enhanced by? What is there MOA?

Back 4

1) synergism with beta-lactams
MOA:
1) block formation of initiation complex
2) misreading of mRNA template
3) inhibit translocation

Front 5

Which bacteria should aminoglycosides be effective against but because they have a cell wall they are not able to penetrate?

Back 5

1) strep
2) enterococci

Front 6

Traditionally antibiotics have been designed to maintain serum MIC for as long as possible. How are aminoglycosides different? Compare to penicillins and cephlosporins?

Back 6

1) have a concentration dependent killing action
a. meaning they killing faster and more organisms above the MIC
2) time-dependent killing of bacteria
a. there efficacy is directly related to time above MIC and becomes independent of concentration once MIC has been reached

Front 7

To achieve the greatest efficacy how should aminoglycosides be administered?

Back 7

1) single large dose because killing actions continue when plasma levels have declined and work better at higher concentrations
2) intramuscularly or IV

Front 8

Are aminoglycosides cidal or static? What is there uptake into host dependent on? As a result they are not effective against which bacteria?

Back 8

1) bactericidal
2) oxygen-dependent transport
3) little activity against strict anearobes

Front 9

What can aminoglycoside uptake be enhanced by? What is there MOA?

Back 9

1) synergism with beta-lactams
MOA:
1) block formation of initiation complex
2) misreading of mRNA template
3) inhibit translocation

Front 10

Which bacteria should aminoglycosides be effective against but because they have a cell wall they are not able to penetrate?

Back 10

1) strep
2) enterococci

Front 11

How are bacteria, especially gram-, resistant to aminoglycosides? Where are they coded for? Which aminoglycoside so far is not effected by this?

Back 11

1) group transferases
a. catalyze acetylation of amine group
2) plasmid mediated resistance
3) streptomycin and netilmicin

Front 12

Which type of bacteria are aminoglycosides predominately used for? What are specific bacteria in this group?

Back 12

1) gram- rods
a. E. coli
b. Enterobacter
c. klebsiella
d. proteus
e. providencia
f. pseudomonas
g serratia

Front 13

Are aminoglycosides when used alone reliably effective against gram + cocci?

Back 13

no

Front 14

What conditions is streptomycin effective in treating?

Back 14

1) tuberculosis
2) plague
3) tuleremia
4) in combination with penicillins for enteroccocal endocarditis

Front 15

What are neomycin and kanomycin used for?

Back 15

1) restricted to topical and oral use for bowel flora
2) neomycin used for bowel surgery

Front 16

What is netilmicin reserved for?

Back 16

infections resistant to other aminoglycosides

Front 17

When is spectinomycin given?

Back 17

1) single dose to treat gonorrhea
2) used in times when people are allergic to beta-lactams

Front 18

What are main side effects of aminoglycosides?

Back 18

1) ototoxicity
2) nephrotoxicity
3) teratogen- newborns have ototoxicity

Front 19

which aminoglycosides effect primarily vestibular apparatus and which effect auditory function?

Back 19

1) vestibular dysfunction: gentamicin and tobramycin
2) auditory dysfunction: amikacin and kanamycin

Front 20

How are the kidneys effected by aminoglycosides? who is this effect more common in?

Back 20

1) acute tubular acidosis
Worse in:
1) elderly
2) people taking:
a. amphotercin B
b. CEPHALOSPORINS
c. vancomycin

Front 21

At high doses what is a rare side effect of aminoglycosides?

Back 21

1) curare-like block resulting in respirtory paralysis

Front 22

Which aminoglycosides are used for systemic use?

Back 22

1) gentamicin
2) amikacin
3) netilmicin
4) tobramycin

Front 23

Which aminoglycosides are used for local use?

Back 23

1) neomycin
2) gentamicin
3) kanamycin

Front 24

Aminoglycoside that is least ototoxic

Back 24

Streptomycin