aminoglycosides Flashcards
MOA
Bind to 16s rRNA in bacteria and disrupt normal cell function also cause frame shifting at 30s ribosomal subunit
Resistance
Happens in 3 ways
1. Metabolism: Acetylation, adenylation, and phosphorylation
2. Altered ribosome: alter the 16s rRNA binding site
3. Decreased aminoglycoside uptake: this would stop after drug is D/C
Toxicity
Ototoxicity and nephrotoxicity
Nephortoxicity can be worsened when taken with loop diuretics
Curare symptoms can be seen with large doses
Respiratory paralysis can be revered with neostigmine or calcium glutonate
Toxicity risk can increase with longer durations of use (Usually occurs in elderly or tx use longer than 5 days)
Therapeutic use
Broad spectrum but usually in practice seen used for gram negative bacteria with penicillin
never put penicillin and aminoglycosides in the same bag as they can react with each other
The two are seen used for bacterial endocarditis
Streptomycin use
Deep IM injection
tuberculosis, bubonic plaque and tularemia
Gentamicin uses
UTI, Burn, some pneumonias, joint and bone infection caused by suseptible gram negative
Amikacin use and how it blocks resistance
Used for aminoglycoside resistant bacteria
The side chain blocks acetylation which thus blocks resistance
Tobramycin use and how it it blocks some parts of resistance
Lacks a C-3 OH group so it avoids phosphorylation but gets adenylated at C-2 and Acetylated at C-3
Used with gentamicin for resistant pseudomonas aeruginosa, parental
Neomycin B and Paromycin uses
Used orally to suppress normal gut flora in travelers Diarrhea and prohyplactically in GI surgery to prevent peritonitis
Neomycin can be used topically
Paromycin can be used to treat amoebic dysentery as well as dwarf tapeworm and beef tapeworm
Plazomicin uses and administration
Treatmed of complicated UTI caused by pneumonia, proteus mirabilis and enterobacter cloacae.
Teratogenic
24 hr IV infusion
