Aminoglycosides

Question 1

aminoglycosides mainly treats what bacteria

Answer 1

serious gram negative infections

Question 2

mechanism of action: where does aminoglycosides initial bind to in cell, what does this cause

Answer 2

• outer membrane of cell

- rearrangement of LPS

Question 3

mechanism of action: how does aminoglycosides cross the cell membrane?

Answer 3

• needs energy from electrochemical gradeint

- trapped in cell

Question 4

what does aminoglycosides bind to inside cell? what does this cause

Answer 4

• 30S and 50s ribosomal subunit

- decreased protein synthesis

Question 5

is aminoglycosides bactericidal or static

Answer 5

cidal, might be static, not fully understood

Question 6

aminoglycosides exhibit what type of dependent killing

Answer 6

concentration dependent killing

Question 7

name two families that are concentration dependent killing

Answer 7

aminoglycosides

fluroquinolones

Question 8

how well is aminoglycosides absrobed

Answer 8

poorly absorbed from GI tract

Question 9

how well is aminoglycosides distributed to lungs

Answer 9

poorly

Question 10

how much and when does aminoglycosides distribute to CSF

Answer 10

20% with inflammation

Question 11

how is aminoglycosides excreted

Answer 11

unchanged via glomerular filtration

Question 12

how does distribution and elimination change for the elderly

Answer 12

decrease both

Question 13

how does distribution and elimination change for the critically ill ( dehydrated or volume overload)

Answer 13

change distribution

Question 14

how does distribution and elimination change for renal disease patients

Answer 14

decrease elimination

change distribution

Question 15

how does distribution and elimination change for the malnourished patients

Answer 15

decrease distribution and creatinine production

Question 16

what are the 1/2 lives of aminoglycosides

Answer 16

they vary

Question 17

what are the two most common aminoglycosides

Answer 17

tobramycin

gentamicin

Question 18

what aminoglycosides is only available in north carolina

Answer 18

amikacin

Question 19

what is the only aminoglycoside given orally

Answer 19

neomycin

Question 20

with high peaks, what adverse effects occur

Answer 20

ototoxicity - impairment in 8th cranial nerve

Question 21

with high troughs, what adverse effect occurs

Answer 21

nephrotoxicity

Question 22

with aminoglycosides what organ must be closely watched

Answer 22

kidney

Question 23

neuromusclar blockage can cause what

Answer 23

prolonged paralysis

Question 24

what organisms does aminoglycosides cover

Answer 24

all gram negative organisms including pseudomonas

gram positive: enterococcus

Question 25

how does aminoglycosides cover staph spp.

Answer 25

synergy

Question 26

what drug is used for tuberculosis

Answer 26

streptomycin

Question 27

what drug is used for brucellosis

Answer 27

gentamicin

Question 28

name 3 uses for oral aminoglycosides? and which aminoglycoside is used for each situation

Answer 28

- suppression of intestinal bacterial flora (neomycin) - hepatic coma (neomycin) - intestinal amebiases: tapeworm (paromomycin)

Question 29

where does one use topical aminioglycosides

Answer 29

ear and eye

Question 30

which aminoglycoside is only available for orally

Answer 30

neomycin

Question 31

what is the most accurate method to determine an individual dose

Answer 31

pharmacokinetc principles

Question 32

what is the least accurate method to determine an individual dose

Answer 32

trial and error

Question 33

what is the first first dose given in a Hartford Nomogram, then how does it work

Answer 33

7mg/kg, adjust dose by peaks and troughs

Question 34

After how many doses is steady state achieved in aminoglycosides

Answer 34

3-4 doses

Question 35

for distribution for aminoglycoside, what part of the organ does it go last

Answer 35

lung

Question 36

where is the highest concentration of aminoglycosides found

Answer 36

urine

Question 37

what happens when there excess trough for aminoglycoside

Answer 37

kidney toxicity

Question 38

aminoglycosides distribute freely where

Answer 38

vascular space