Aminoglycosides Flashcards
aminoglycosides mainly treats what bacteria
serious gram negative infections
mechanism of action: where does aminoglycosides initial bind to in cell, what does this cause
- outer membrane of cell
- rearrangement of LPS
mechanism of action: how does aminoglycosides cross the cell membrane?
- needs energy from electrochemical gradeint
- trapped in cell
what does aminoglycosides bind to inside cell? what does this cause
- 30S and 50s ribosomal subunit
- decreased protein synthesis
is aminoglycosides bactericidal or static
cidal, might be static, not fully understood
aminoglycosides exhibit what type of dependent killing
concentration dependent killing
name two families that are concentration dependent killing
aminoglycosides
fluroquinolones
how well is aminoglycosides absrobed
poorly absorbed from GI tract
how well is aminoglycosides distributed to lungs
poorly
how much and when does aminoglycosides distribute to CSF
20% with inflammation
how is aminoglycosides excreted
unchanged via glomerular filtration
how does distribution and elimination change for the elderly
decrease both
how does distribution and elimination change for the critically ill ( dehydrated or volume overload)
change distribution
how does distribution and elimination change for renal disease patients
decrease elimination
change distribution
how does distribution and elimination change for the malnourished patients
decrease distribution and creatinine production
what are the 1/2 lives of aminoglycosides
they vary
what are the two most common aminoglycosides
tobramycin
gentamicin
what aminoglycosides is only available in north carolina
amikacin
what is the only aminoglycoside given orally
neomycin
with high peaks, what adverse effects occur
ototoxicity - impairment in 8th cranial nerve
with high troughs, what adverse effect occurs
nephrotoxicity
with aminoglycosides what organ must be closely watched
kidney
neuromusclar blockage can cause what
prolonged paralysis
what organisms does aminoglycosides cover
all gram negative organisms including pseudomonas
gram positive: enterococcus
how does aminoglycosides cover staph spp.
synergy
what drug is used for tuberculosis
streptomycin
what drug is used for brucellosis
gentamicin
name 3 uses for oral aminoglycosides? and which aminoglycoside is used for each situation
- suppression of intestinal bacterial flora (neomycin)
- hepatic coma (neomycin)
- intestinal amebiases: tapeworm (paromomycin)
where does one use topical aminioglycosides
ear and eye
which aminoglycoside is only available for orally
neomycin
what is the most accurate method to determine an individual dose
pharmacokinetc principles
what is the least accurate method to determine an individual dose
trial and error
what is the first first dose given in a Hartford Nomogram, then how does it work
7mg/kg, adjust dose by peaks and troughs
After how many doses is steady state achieved in aminoglycosides
3-4 doses
for distribution for aminoglycoside, what part of the organ does it go last
lung
where is the highest concentration of aminoglycosides found
urine
what happens when there excess trough for aminoglycoside
kidney toxicity
aminoglycosides distribute freely where
vascular space
