Aminoglycosides Flashcards
What are the 5 aminoglycosides?
- streptomycin
- tobramycin
- gentamicin
- amikacin
- neomycin
What do aminoglycosides do?
Aminoglycosides inhibit protein synthesis by binding to the 30s ribosomal subunit
What is the mode of administration for streptomycin and what does it treat?
IV/IM
second line TB drug
what is the mode of administration for gentamicin?
IV/IM/Topical
what is the mode of administration for Tobramycin?
IV/IM/topical
what is the mode of administration for amikacin?
IV/IM
what is the mode of administration for neomycin?
topical/PO
Describe the structure of aminoglycosides and how this affects their pharmacokinetics?
Aminoglycosides are amino sugars in glycosidic linkage. They are polycations. Their polarity affects their absorption and distribution (it explains why they must be taken in combination with inhibitors of cell wall synthesis)
What do aminoglycosides do to the 30s ribosomal subunit?
They irreversibly bind to the 30s ribosomal subunit and block its activity. Because this binding is irreversible, aminoglycosides are bacteriocidal!
What requirements must be met for aminoglycosides to be functional?
Aminoglycosides must be actively transported into the bacterial cells which involves the use of O2. Therefore, aminoglycosides are only useful against aerobic and not anaerobic bacteria
In general, when are aminoglycosides used?
They are used to specifically treat aerobic G- enteric (rods) bacteria. They are also used when sepsis or endocarditis is suspected.
Streptomycin uses:
- tularemia
- bubonic plague
- TB
- endocarditis (part of combination therapy)
which aminoglycosides are effective against P. aeruginosa?
gentamicin, tobramycin, amikacin
Neomycin and gentamicin uses:
topical application of wounds and burns caused by aerobic G- bacteria
gentamicin is also active against P. aeruginosa
What is the DOC for enterococcus species?
penicillin + aminoglycosides
Explain resistance and synergism when it comes to aminoglycosides and ICWS:
Aminoglycosides are too large and polar to enter the cells on their own. They are unable to cross the membrane. ICWS have a hard time completely breaking down the walls of G- bacteria but they are able to weaken it. ICWS weaken the cell walls of G- bacteria enough to allow the aminoglycosides to enter the cells and bind to the 30s ribosomal subunit irreversibly, where the inhibit protein synthesis and cause the cell to die.