Aminoglycosides Flashcards
aminoglycoside drugs
gentamycin
tobramycin
amikacin
streptomycin
plazomycin
aminoglycoside mechanism of action
inhibits protein synthesis by irreversibly binding to 30S ribosomal subunits
and 50S subunits (tobra, gent, amikacin)
aminoglycosides mechanism of resistance
altered aminoglycoside uptake
synthesis of aminoglycoside modifying enzymmes
alteration in ribosomal binding sites
general spectrum aminoglycosides
gram positive (in combo, gent)
gram negative (high dose)
target organisms gentamycin
MSSA (in combo)
MRSA (in combo)
pseudomonas
target organisms amikacin, tobramycin, plazomycin
pseudomonas
are aminoglycosides absorbed orally
no
do aminoglycosides penetrate CSF
no, too polar
how are aminoglycosides used
in synergy with beta lactams or vanc
adverse effects of aminoglycosides
nephrotoxicity
ototoxicity
neuromusclar blockade
low dose or high dose gram positive dose in aminoglycosides
low dose
low dose or high dose gram negative dose in aminoglycosides
high dose
target gentamycin and tobramycin concentrations for a moderate infection (UTI)
peak and trough
peak: 4-6
trough: 0.5-1.5
target gentamycin and tobramycin concentrations for a moderate to severe infection (skin, soft tissue, bloodstream)
peak: 6-8
trough: 1-1.5
target gentamycin and tobramycin concentrations for a severe infection (burn, pnemonia, life threatening)
peak: 8-10
trough: <2
target gentamycin gram positive synergy peak and trough
peak: 3-5
trough: 1
target gentamycin tobramycin once daily dosing gram negative only
peak: 13-20
trough: <0.5 (undetectable)
extended interval dosing only for what organismjs
gram negative
risk factors for ototoxicity and nephrotoxicity
prolonged high troughs (>2)
long duration of therapy
renal insuf
age
hypovolemia
nephrotoxin use (cisplatin,vanc)
extended interval dosing only for what doses
5-7 mg/kg gent or tobra in gram neg
