Aminoglycosides and Broad Spectrum

Question 0

Kanamycin

Answer 0

Aminoglycoside: inhibit protein synth, binds 30s, requires O2, -cidal
Use: G- combine w/ B-lactam, sepsis
Pre-op suppression
Tox: nephrotoxic (+cephalosporins, vancomycin, cisplatin, cidofovir), ototoxic (+loop diuretics), NM weakness, GI

Question 1

Streptomycin

Answer 1

Aminoglycoside: inhibit protein synth, binds 30s, requires O2, -cidal
Use: G- combine w/ B-lactam, sepsis
Tularemia, Bubonic plague, TB, Endocarditis
Tox: nephrotoxic (+cephalosporins, vancomycin, cisplatin, cidofovir), ototoxic (+loop diuretics), NM weakness, GI

Question 2

Neomycin

Answer 2

Aminoglycoside: inhibit protein synth, binds 30s, requires O2, -cidal
Use: G- combine w/ B-lactam, sepsis
Pre-op suppression, Hepatic encephalopathy, topical (wounds/burns)
Tox: nephrotoxic (+cephalosporins, vancomycin, cisplatin, cidofovir), ototoxic (+loop diuretics), NM weakness, GI

Question 3

Gentamicin

Answer 3

Aminoglycoside: inhibit protein synth, binds 30s, requires O2, -cidal
Use: G- combine w/ B-lactam, sepsis
Topical (wounds/burns)
Tox: nephrotoxic (+cephalosporins, vancomycin, cisplatin, cidofovir), ototoxic (+loop diuretics), NM weakness, GI

Question 4

Paramomycin

Answer 4

Aminoglycoside: inhibit protein synth, binds 30s, requires O2, -cidal
Use: G- combine w/ B-lactam, sepsis
Intestinal amebiasis
Tox: nephrotoxic (+cephalosporins, vancomycin, cisplatin, cidofovir), ototoxic (+loop diuretics), NM weakness, GI

Question 5

Chloramphenicol

Answer 5

Reversibly binds 50s, inhibits peptide bond forming, -static
Liver met by conjugation (glucuronic acid), broad spectrum
Resistance: plasmid encoded acetyl transferase
Not for: entamoeba histolytica, pseudomonas
2nd line for typhoid fever, meningitis, eye infx, G-, rickettsia, brucellosis, RMSF
Tox: reversible bone marrow depression (dose dep), fatal aplastic anemia (dose indep), Gray baby synd, hemolytic anemia (G6PD def), superinfx
Don’t use w/ erythromycin