Aminoglycosides Flashcards
Aminoglycosides MOA
Passes thru bacterial membrane and binds to 30s subunit, inhibiting protein synthesis. Increases membrane leakage
Aminoglycoside resistance
Transferase enzyme produced by bacteria inactivate aminoglycoside.
Impaired entry into cell.
Aminoglycoside pharmacokinetics
Poorly distributed and poorly protein bound.
Good distribution in patients with ascites, burns, pregnancy
Not metabolized, 99% of dose is excreted unchanged in the urine.
Is a dose adjustment of aminoglycoside required for renal insufficiency? hepatic?
Renal because that is how it is excreted
Not hepatic because it is not metabolized.
Aminoglycosides work against….
Aerobic gram negative bacilli: Pseudomonas Enterobacter Serratia Acinetobacter Klebsiella
Aminoglycosides are synergistic with ….?
Beta Lactams
Against gram positive
Aminoglycosides show ____ _____ killing.
Dose dependent (concentration dependent)
Gentamicin (Garamycin)
Most widely used
Effective for gram + and -
Almost always used with beta lactam
IV, IM, topical and opthalmic
Gentamicin dose
1 - 1.7 mg/kg IM/IV q 8-12 hrs
OR
4- 7 mg/kg once daily
Tobramycin (Nebcin)
SImilar coverage to gentamicin except better for pseudomonas and more expensive.
Can inhale for cystic fibrosis
IV, IM, opthalmic
Tobramycin dose
1 - 1.7 mg/kg IM/IV q 8 hrs
Amikacin (Amikin)
Used for resistant bacteria
IV/IM
Dose: 7.5 mg/kg IM/IV q12
Streptomycin
2nd line for TB
Used in combo with penicillin for enterococcus endocarditis
Dose: 1 - 2 g IM q12
Neomycin (Mycifradin)
Limited to topical and oral use
Bowel prep for surgery
DoseL 1g PO q 6-8 x 2days
Paromycin (humatin)
For intestinal amebiasis and hepatic coma/encephalopathy
Oral
