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medical techonology 2nd year 3rd shiftings > Aminoglycodides > Flashcards

Aminoglycodides Flashcards

1
Q

Modes of antibacterial action : concentration dependent

A
  • Some drugs and aminoglycosides
  • As the PLASMA LEVEL IS INCREASED ABOVE THE MIC, the drug kills an increasing proportion of bacteria at a more rapid rate

Plasma Level + = Kills bacteria faster

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2
Q

MODES OF ANTIBACTERIAL ACTION :
TIME DEPENDENT

A
  • Any antibiotics, including Penicillin and
    Cephalosporins
  • Directly related to time above MIC
  • Independent of concentration once
    the MIC is reached

MIC : Minimum Inhibitory Concentrations

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3
Q

MODES OF ANTIBACTERIAL ACTION : POSTANTIBIOTIC EFFECT

A
  • Aminoglycosides’ killing action continues when the plasma levels have declined below measurable levels
  • It is a phenomenon where the antibiotic continues to inhibit bacterial growth even after the drug has been removed.
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4
Q

MODES OF ANTIBACTERIAL ACTION : POSTANTIBIOTIC EFFECT

A
  • Greater efficacy when administered as a SINGLE LARGE DOSE than when given as multiple smaller doses
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5
Q

AMINOGLYCOSIDES : PHARMACOKINETICS

A
  • Structurally related amino sugars
    attached by glycosidic linkages
  • Polar compounds
  • Not absorbed orally
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6
Q

AMINOGLYCOSIDES : PHARMACOKINETICS

A
  • Given intramuscularly or intravenously
    for systemic effects
  • Limited tissue penetration
  • Do not readily cross the blood-brain barrier
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7
Q

Major mode of excretion

A

Glomerular Filtration

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8
Q

Plasma levels are affected by the changes of ?

A

Renal Function

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9
Q

Excretion is directly propotional to ?

A

Creatine Clerance

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10
Q

With normal Renal funtion, elimination half-life is ?

A

2-3 Hours

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11
Q

Dosage adjsutment must be made in__________to avoid_______?

A

Made in Renal Insufficiency to avoid Toxicity accumulation

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12
Q

Monitoring what levels is needed for safe anf effective dosage selection and adjustment ?

A

Plasma levels

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13
Q

Traditonal Dosing regiments ?

A

2 to 3 times a day

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14
Q

When is the Peak serum levels ?

A

30-60 minuties after administering

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15
Q

Trough serum levels

A

Refers to the lowest concentration of a drug in the bloodstream, reached just before the next dose is administered.

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16
Q

Bactericidal

A
  • Substances that destroys microorganisms.
  • They are Irreversible inhibitors of protien synthesis
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17
Q

Penetration of bacterial cell wall is partly dependent on ?

A

O2 dependent active transport

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18
Q

Transport is enhanced by ?

A

Cell wall synthesis inhibitors
- Due to the accumulation of intermediates in the cell wall synthesis pathway, which increases the concentration of substrates available for transport

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19
Q

Bactericidal

A

Kills the bacteria.
● Something like suicide or homicide
● Actually kills the intended bacteria

20
Q

Minimum Inhibitory Concentration

A

The lowest concentration of an antimicrobial (like an antifungal, antibiotic, or bacteriostatic) drug that will inhibit the visible growth of a microorganism after overnight incubation.
● In-vitro quantitative measure of how much concentration of antibiotic will be able to inhibit the growth of bacteria.

21
Q

Selective Toxicity

A

The aim of antimicrobial therapy is TO KILL or INHIBIT the INFECTIVE ORGANISIM WITHOUT DAMAGING THE HOST.

22
Q

Bacteriostatic

A

Prevents the growth of bacteria.
- Does not kill bacteria but it prevents its reproduction, thereby allowing the immune system to take over.

23
Q

ANTIMICROBIALS

A
  • Drugs that inhibit the growth/replication or kill microorganisms.
    ○ Antibacterial
    ○ Antifungal
    ○ Antiviral
    ○ Antiprotozoal
    ○ Antiparasitic
24
Q

BACTERIAL STRUCTURE

A

○ Cell membrane
○ Nucleus (no nuclear membrane, but has nucleoid structure to contain their chromosomes)
○ Fmbriae
○ Pili
○ Some may develop a capsule

25
Cell membrane
**Composed of lipid bilayer** so it can **easily be disrupted with substances** that can **disrupt the hydrophobics** of this structure **such as alcohols.**
26
Cell wall: Carbohydrate-based
For bacteria, it is peptidoglycan (has protein and peptide but mostly composed of carbohydrates).
27
Aminoglycosides binds to ____ S ribosomal unit ?
30S ribosomal unit
28
Aminoglycosides interfere with protein synthesis like :
1. **Blocks formation** of initiation complex 2. **Inhibit Translocation** 3. **Causes misreading** of the code on the mRNA template
29
Aminoglycosides mechanisim of resistance :
Resistant **due to failure to penetrate into the cell** **Examples are :** ▪**Streptococci, including S. pneumoniae** ▪**Enterococci**
30
Clinical Uses : Gentamicin, Tobramycin, Amikacin
**Serious infections** caused by **Aerobic gram (-) bacteria** ▪**P**rovidencia (Pseudomonas) ▪**E**. coli (Enterobacter) ▪**K**lebsiella (Proteus) ▪**S**erratia | **GAT = PEKS **
31
Gentamicin, Tobramycin, Amikacin Used for the following but is not the drug of choice:
Used for the following but is not the drug of choice ▪H. influenzae ▪M. catarrhalis ▪Shigella species
32
Anti-bacterial Synergy
if Combined with Penicillin in the treatment - **P**seudomonal Infections - **L**isterial Infections - **E**nterococcal Infections | Antibiotics + Penicillin = **PLE**
33
Streptomycin
For : - Tubercolosis - Plague - Tularemia - Multi-Drug-Resistance (MDR) straibs of M. tb resistanct to streptomycin maybe susceptible to amikacin
34
Neomycin, Kanamycin, Paromycin
Topical - Neomycin IM/IV/PO (Orally) - Kanamycin, Paromycin Active against : Gram possitive bacteria Gram negative bacteria some mycobacteria Resistant: P aeruginosa, Streptococci
35
Netilmycin
- IM/IV/Topical/Ocular/Intrathecal - **Reserved for serious infections** resistant to other aminoglycosides | Intrathecal : administered into the spinal theca
36
Spectinomycin
Aminocylitol related to aminoglycosides * Back-up drug ***Intramuscular as single dose for Gonorrhea** * NOT recommended for treatment of pharyngeal gonococcal infections
37
# Toxicity OTOTOXICITY
**Auditory or Vestibular damage (or both) maybe irreversible.** ▪ **Auditory** impairment - Amikacin and Tanamycin ▪ **Vestibular** dysfunction - Gentamicin and Tobramycin
38
OTOTOXICITY
- The **risk** is **proportionate** to the **plasma levels** * HIGH if the dosage is not modified in renal dysfunction - Increased with the use of loop diuretics - **Contraindicated during pregnancy** | **Contraindictated : not advised as a course of treatment**
39
NEPHROTOXICITY
- Causes **Tubular Necrosis** - Cause **Liver damage** - It **is Reversible** **- Most Nephrotoxicity ** * **Gentamicin** * **Tobramycin** ## Footnote Gentamicin : Treatment both gram-positive and gram-negative infections, Aerobic Infections. Tobramycin : Treatment both gram-positive and gram-negative infections, Aerobic Infections. Both are used to treat Pseudomonas aeruginosa in people diagnosed with cystic fibrosis.
40
NEPHROTOXICITY
- Most **common in ELDERLY PATIENTS** - **also** patients **concurrently receiving ** * **Am/pho/te/ri/cin B** * **Ce/pha/lo/spoh/orins** * **Van/co/mycin** Amphotericin B : Anti-Fungal Cephalosporins : Bacterial Antibiotics Vancomycin : Glycopeptide antibiotic
41
NEUROMUSCULAR BLOCKADE
- **Rarely Happens** - Curare-like block **may occur at high doses** * **Causes Respiratory Paralysis** - It **is REVERSIBLE**
42
Neuromuscular Blockade Treatment
- Calcium - Neostigmine - Ventilatory Support
43
Minimum Inhibitory Concentration (MIC)
- The lowest concentration of a chemical that prevents visible growth of bacteria or fungi.
44
When is Trough Serum Levels Measured ?
Measured **just before the next dose**
45
Bacteriostatic
- Substances that **inhibits microbial growth**.

medical techonology 2nd year 3rd shiftings (7 decks)

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