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Drugs - Allman > Aminoglycoside > Flashcards

Aminoglycoside Flashcards

1
Q

Mechanism of action

AMG

A

Binds to outer membrane of cell –> LPS re-arrangement

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2
Q

AMG uptake is _____ dependent. What is the source?

A

Energy dependent

source: electrochemical gradient

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3
Q

What happens once the drug crosses the membrane?

AMG

A

Irreversibly trapped
binds 30S and 50S ribosomal subunit –> decreased protein synthesis and misreading of mRNA

Very high intracellular concentrations

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4
Q

Is AMG bactericidal or bacteriostatic?

A

bactericidal

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5
Q

_____ dependent killing with ______

A

Concentration. PAE.

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6
Q

How is the absorption from GI tract?

AMG

A

Poor

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7
Q

Lowest site of distribution

AMG

A

lungs

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8
Q

How is the AMG excreted?

A

99% unchanged via glomerular filtration

high urinary conc

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9
Q

Best AMG for treatment? Why?

A

Gentamicin. Desired peak 4-12, trough

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10
Q

What is the hallmark adverse effect of AMG?

A

Nephrotoxicity

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11
Q

What are the consequences of high peaks? high trough?

AMG

A

High peaks - Ototoxicity (ears)

hight troughs - Nephrotoxicity (kidney)

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12
Q

Spectrum of activity: organisms covered?

AMG

A

Gram negative - excellent
enterococcus - synergy
Staph spp. sensitive (in vitro)

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13
Q

Treatment of which organism shows synergy? What is the drug combo?
(AMG)

A

Enterococcus
Ampicillin - cell wall
Gentamycin - kill

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14
Q

what are the uses for oral AMG?

A
  • suppression of intestinal bacterial flora - for colorectal surgical prophylaxis
  • Hepatic coma - decrease in ammonia-forming bacteria
  • hyperlipidemia - reduces cholesterol absorption
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15
Q

What is the oral AMG used?

A

Neomycin

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16
Q

A method used for individualization of dose - acceptable for initial dosing and then adjusted
(AMG)

A

Nomogram

17
Q

What are the three main AMG?

A

Gentamicin
Tobramycin
Amikacin

18
Q

what is the most accurate method for individualization of dose?

A

Pharmacokinetic principle

- lowest toxicity and lowest failure rates

Drugs - Allman (16 decks)

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