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34 Cards in this Set
- Front
- Back
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TQ: adverse effects of aminoglycosides?
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ototoxicity and nephrotoxicity and neuromuscular paralysis (think boxer)
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are aminoglycosides absorbed folowing oral administration
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no
Ally systemically active aminoglycosides must be given parenterally to attain therapeutic serum concentrations |
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TQ: adverse effects of aminoglycosides?
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1) ototoxicity
2) nephrotoxicity 3) neuromuscular paralysis (think boxer) |
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mechanism of action of aminoglycosides
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interacts w 30s ribosomal subunit, inhibting bacterial protein sythesis
1)interfere with the formation of initiation complex Interfere with initiation codon functions by blocking association of the 50S ribosomal subunit with mRNA-30S. (-static) Misreading of code-incorporation of wrong AA (-cidal) |
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what are aminoglycosides commonly synergistic with
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b-lactams
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which drug has post-antibiotic effect
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aminoglycosides
- their killing action continues w/ residual bactericidal activity when their serum leves have declined |
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are aminoglycosides active against aerobic or anaerobic?
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only aerobic
enters gram neg organism through oxygen-dependent system. |
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Which aminoglycosides could be used against MRSA
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gentamicin and tobramycin
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which aminoglycoside is first line for pseudomonas aeruginosa
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tobramycin
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Which aminoglycosides are not used systemically
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neomycin and kanamycin
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Which drug can cause permanent deafness?
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aminoglycosides
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Aminoglycosides (6)
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-30s
-Bactericidal K-GNATS -Kanamycin -Gentamicin -Neomycin -Amikacin -Tobramycin -Stretomycin |
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Aminoglycosides properties
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-30s
-Bactericidal -active against Aerobic gram negative bacilli -post-antibiotic effect: their bacteriacidal effects continue even below minimal inhibitory concentrations (MIC). -large daily doses better than multiple smaller doses -synergistic with B-lactams |
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Streptomycin is DOC for what 2 gram negative bacilli?
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1)Yersinia pestis (+ tetracycline)
2) Francisella tularensis (tularemia) |
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Gentamicin is the DOC/1st line for what causes of endocarditis and bacteremia?
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1) Enterococcus (DOC)
2) Viridans sptrep 3) Group A strep 4) Camplyobacter fetus |
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Gentamicin is the 1st line for what causes of meningitis?
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1) Group A strep
2) Listeria |
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What aminoglycoside is 1st line for Brucella (Brucellosis)?
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Gentamycin
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optic damage has been observed in what aminoglycoside?
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streptomycin
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contact dermatitis has been observed in what aminoglycoside?
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neomycin (topical)
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what drugs may increase nephrotoxicity when taken with Aminoglycosides?
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Loop diuretics
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Gentamicin,Tobramycin, Amikacin are used to what 5 severe infections?
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GAT may treat severe infections:
-Bacteremia -Endocarditis -Meningitis -Pneumonia -Chronic UTIs |
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Aminoglycoside that is typically used topically, but is employed orally for bowel sterilization and a hepatic coma?
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Neomycin
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what Aminoglycoside should not be used for Serratia or Pseudomonas. Also may be employed for surgical prophylaxis.
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Kanamycin
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Aminoglycoside mechanism of resistance
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MCC: Formation of enzymes that inactivate drugs via conjugation reactions that transfer acetyl, phosphoryl, or adenylyl groups
-Altered uptake of drug due to lack of active transport mechanism -altered 30s ribosomal target |
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what Aminoglycoside is less susceptible to enzymatic inactivation?
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amikacin
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Aminoglycosides should not be used for what group of bacteria?
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Aminoglycosides acumulate intracellulary in microorganisms via an O2 dependent uptake. Therefore anaerobes are innately resistant.
Anerobes. -Actinomyces -Bacteroides -Clostridium -Fusiform |
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What aminoglycosides are very effective against most gram-neg aerobes, and used to treat severe infections
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Gentamicin,Tobramycin, Amikacin
-bacteremia -endocarditis -miningitis -pneumonia -chronic UTIs |
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How would you treat Brucellosis?
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Doxycycline + gentamycin
Brucella |
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what is the broadest spectrum aminoglycoside?
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Amikacin
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UTI bugs
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1) E.Coli
2) Staph Saprophyticus 3) Klebsiella pneumoniae -Serratioa marcescens -Enterobacter clocae -Proteus mirabilis -Pseudomonas aeruginosa |
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Aminoglycosides excretion
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glomerular filtration
dose adjustment required in renal insufficiency. |
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why are aminoglycosides good at treating aerobic gram neg bacilli?
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Aminoglycosides are highly water soluble due to their polar hydroxyl and Amine groups. Being polar allows aminoglycosides to cross gram neg membranes via porins.
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how does the aminoglycosides being polar affect it's distribution.
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Aminoglycosides are highly water soluble due to their polar hydroxyl and Amine groups.
This results in poor bio-availability via oral absorption and poor distribution in the bones, CNS, and fatty tissues |
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how does the aminoglycosides being polar affect it's excretion?
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Aminoglycosides are highly water soluble due to their polar hydroxyl and Amine groups.
water soluble drugs: Renal elimination |
