Aminoglycosides Flashcards

1
Q

What bacteria do they act on?

A

Negative

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2
Q

What are examples of aminoglycosides

A

Gentamicn
Neomycin
Tobramycin
Streptomycin
Amikacin

NOT VANCOMYCIN

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3
Q

What does pseudemonas aerigonsa cause

A

Pneumonia

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4
Q

Which aminoglycosides used for penumonia

A

T A G

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5
Q

What is streptomycin used for

A

Mycobacterium TB

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6
Q

What is maximum duration of aminoglucosides

A

7 days

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7
Q

Should aminoglycosides be used in pregnancy

A

no

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8
Q

What route should aminoglycosides be administered via

A

IV only as absorbed by the gut

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9
Q

Infections aminoglycosies can be used for

A

Endocarditis (gent with another abx)
Pyelenophritis (amikacin, gent)
Severe sepsis

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10
Q

When organism unknown what should aminoglycosides be used in combo with

A

Penicillin
Metronidazole

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11
Q

MOA of aminoglycosides

A

Inhibit protein synthesis

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12
Q

Cautionary warning side effect of aminoglycosides

A

Nephrotoxcitiy
Ototoxicity

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13
Q

Signs of nephrotoxicity

A

Increase creatine, decreased urine, protein/ hematuria
Swelling of ankles
Fatigue
SOB
Fluid retention

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14
Q

Ototoxicity signs

A

Ringing in ears
Dizzy
Reduced hearing
Uncoordinated movements

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15
Q

MHRA warning of aminoglyc

A

Histamine related adverse effect of specially in patients with histamine releasing drugs like opioids

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16
Q

What drug causes increased ototoxicity with aminoglyc

A

Loop diuretics

17
Q

What drugs increases nephrotoxicity with aminoglyc

A

Ciclosporin
Vancomycin
Cephalosporin (cefalexin, cectriaxone - cefs)

18
Q

What to do with doses in renal impairment and aminoglycosides

A

Renal impairment increase dose interval

Severe impairment decrease dose

19
Q

When to monitor aminoglycoside in multiple dose regimen

A

After 1 hour of dose

20
Q

Contraindication of aminoycsoide

A

Myasthenia Gravis
(Uncoordinated muscle movement)

21
Q

What to monitor in aminoglycosides

A

Renal function
Vestibular function
Auditory function
Plasma conc

22
Q

Monitoring in which patients on aminoglycosides is needed more

A

Obese
Elderly
Renal impairment
High doses with cystic fibrosis
Increased dose or dose change
Those with parental route

23
Q

Warning signs of aminoglycsodies

A

Nephrotoxicity
Ototoxicity
Dehydration - ensure patient well hydrated before

24
Q

Max duration of treatment with aminoglycosides

A

7 days

25
Q

Why is Amikacin used

A

Least susceptible to enzyme inactivation and used in gentamicin resistant infections

26
Q

What route should be avoided with neomycin

A

PARENTERAL

27
Q

what route is seen with tobramycin

A

Inhaler / nebuliser

28
Q

Is vestibular damage reversible

A

no

29
Q

Range for once daily gentamicin

A

Peak 5-10
Trough < 2

30
Q

Range for multiple dose regimen in endocarditis

A

Peak 3-5
Trough <1

31
Q

Side effects of gentamicin

A

Nephrotoxicity
Otoxicity
Dizziness
Depression
Blood disorder
Tinnitus
N&v
Neurotoxicity
Skin reactions

32
Q

What to do in renal impairment with aminoglycosides

A

Renal impairment = reduce interval
Severe impairment = reduce dose

33
Q

What indication causes multiple daily dose regimen in aminoglycosides

A

Endocarditis

34
Q

What creatinine clearance causes multiple dose regimen to be preferred

A

<20

35
Q

If a person is fat what to do with dose

A

Decrease aminoglycoside dose