13. Aminoglycosides Flashcards
Aminoglycosides
Neomycin
Paromycin
Streptomycin
Gentamicin
Tobramycin
Amikacin
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-binding to the 30s ribosomal subunit
-activity against aerobic gram negatives, actively transported cell membrane
-coupled with cell wall active drugs
(beta-lactams, vancomycin) to allow entry into the cell
-transported into bacteria via an oxygen dependent process (aerobic bacteria)
- *-ivy administration**
-Neomycin remains active in the GI tract until secreted with feces
- neomycin used in bowel prep before colorectal surgery
- Paromycin, luminal agent active against parasital infections
- ——————————————————————————–streptomycin treats tularemia caused by Francisella tularensis
- streptomycin treats the plague caused by Yersinia pestis
- gentamycin treats resistant gram negative infections (Enterobacter, serratia, Klebsiella)
-systemic gram negative infections
(septicemia, nosocomial RTI, complicated UTI, intra-abdominal infection)
- activity against pseudomonas (aerobic gram negative)
- tobramycin -activity similar to gentamycin
- activity against enterococcus when coupled with a cell wall active agent (penicillin, vancomycin)
-inactivated by an acetylation enzyme
(E. faecium against tobramycin)
- Amikacin Activity against E. faecium w/ acetylation enzymes
-Activity against pseudomonas
(gentamycin, tobramycin, amikacin)
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-myasthenia gravis is an absolute contraindication to aminoglycoside use, due to post NMJ Blockade
-Teratogenic – deafness in newborn
ototoxicity (vestibular or cochlear damage)
- nephrotoxicity (due to acute tubular necrosis)
- acute tubular necrosis (brown casts)
Peaks and troughs in undulating terrain: monitoring of serum drug levels