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25 Cards in this Set

  • Front
  • Back
How do you recognize Aminoglycoside names?
End in "mycin".
AG's are mostly used against?
gram negative enteric bacteria (in bacteremia and sepsis), or in combo with Vancomycin or PCN for endocarditis, or for TB
AG MOA?
Irreversible inhibitors of protein synthesis. Passive diffusion through porin channels in out membrane. Actively transported across cell membrane (O2 dependent). This transport powered by electrochemical gradient and coupled to a proton pump. Transport may be enhanced by PCN and vanco. Inhibited by low extracellular pH and no O2. AG binds to 30S ribosomal subunit and inhibits protein synthesis
3 ways AG's inhibit protein synthesis?
Interefere with initian complex

Misread mRNA

Breakup ribosomes
3 mechanisms of AG resistance?
1. Production of a transferase enzyme that deactivates the AG.

2. Impaired entry of AG into cell. (mutation of porin gene)

3. Alter 30S receptor
Why are single, large doses of AG's better?
Concentration dependent killing. Postantibiotic effect. No more (often less) toxic.
How are AG's secreted? What level should be monitored?
Kidney. Creatinine Clearance should be monitored
Do AG's reach CSF?
AG's are largely excluded from CSF and eye, but can reach 20% of plasma levels if active inflammation is going on.
High doses of AG’s cause a “curare like” effect of respiratory paralysis. How is this reversed?
Calcium Gluconate or Neostigmine
Two important side effects of AG’s?
Ototoxic, Nephrotoxic
Streptomycin is mainly used to treat what disease?
TB
Streptomycin serious side effect?
Vestibular problems. Vertigo
If an organism (enterococci) is resistant to gentamycin, what drug should be used?
Streptomycin
Streptomycin is often used in combo with what drug for Plague, Tularemia, Brucellosis?
Oral Tetracycline
Gentamycin is effective against?
Gram + and - organisms.
Gentamycin should not be used alone against what organisms? Why not?
Staph. Resistance develops rapidly.
Why should AG's not be used as a single agent therapy for PNA?
penetration of lung tissue is poor, and low pH, and low O2.
Side effects of gentamycin?
Bad Ototoxicity, mild nephrotoxicity.
What's the difference between gentamycin and tobramycin?
Tobramycin is more effective against psudomonas and less effective against serratia.
What organism is resistant to Tobramycin?
Enterococcus faecium
Why is Gentamycin prefered to Tobramycin?
Gentamycin is cheaper
When are Amikacin and Netmilcin used and why?
Amikacin is resistant to enzymes that break down gentamycin and tobramycin (and others) so it is used against organisms that are resistant to these drugs.
Side effect of Amikacin?
Ototoxic, especially to auditory portion of CN VIII
Side effects of Neomycin and Kanamycin?
Highly Nephrotoxic and Ototoxic. Auditory>Vestibular. rarely used today.
Spectinomycin used to tx what disease?
Gonorrhea