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Pharmacology > Aminoglycosides And Spectinomycin > Flashcards

Aminoglycosides And Spectinomycin Flashcards

1
Q

The active transport of aminoglycosides into the cytoplasm is oxygen dependent. From where is the source of energy for the transport?

A

Transmembrane electrochemical gradient

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2
Q

TRUE or FALSE: The MOA of aminoglycosides is enhanced by low extracellular pH and anaerobic conditions

A

FALSE. INHIBITED DAPAT

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3
Q 
Which of the following drugs enhance the action of aminoglycosides?
A. Penicillin
B. Vancomycin
C. Cell wall active drugs
D. All of the above
A

D

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4
Q

What are the three mechanisms for the inhibition of CHON synthesis by aminoglycosides?

A
  1. Interfere with initiation complex of peptide formation
  2. Misreading of mRNA
  3. Breakup of polysomes to nonfunctional monosomes
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5
Q

TRUE or FALSE: Aminoglycosides are well absorbed in the GIT

A

False

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6
Q

What is the choice of administration for aminoglycosides?

A

IV (30-60min infusion)

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7
Q

What is the half life of aminoglycosides for patients with renal impairment?

A

24-48hrs

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8
Q

What is the normal half life of aminoglycosides?

A

2-3hrs

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9
Q 
This property of aminoglycosides is its ability to persist its antibacterial activity beyond the time during which measurable drug is present
A. Concentration Dependent Killing
B. Post-antibiotic effect
C. Synergistic Killing
D. 30s ribosomal CHON binding
A

B

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10
Q 
This property of aminoglycoside is exhibited when administered with Beta lactams
A. Concentration Dependent Killing
B. Post-antibiotic effect
C. Synergistic Killing
D. 30s ribosomal CHON binding
A

C

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11
Q 
As the concentration increases, the number of bacteria that is killed also increases at a more rapid rate in aminoglycosides
A. Concentration Dependent Killing
B. Post-antibiotic effect
C. Synergistic Killing
D. 30s ribosomal CHON binding
A

A

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12
Q

What is the toxic trough concentration in aminoglycosides?

A

2mcg/ml

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13
Q

In patients with normal renal function, which among the once/daily dose or the traditional 2-3x/d is preferred?

A

Creat clearance >60ml/min = once/day

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14
Q

What is the preffered dosing of aminoglycosides in patients with creatinine clearance less than 60ml/min

A

Traditional administration (2-3x/d)

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15
Q

A 45kg patient with creatinine clearance of 68ml/min is prescribed with gentamicin. How much drug must be infused to the patient and in what dosing?

A

225-315mg/d
(5-7mg/kg = gentamicin)
Daily dosage since creat clearance is beyond normal limits

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16
Q

What is the earliest indication of nephrotoxicity in aminoglycoside toxicity?

A

Increased of aminoglycosides in trough serum conc

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17
Q

What drugs worsen the nephrotoxic effect of prolonged use of aminoglycosides?

A

Loop diuretics, Vancomycin, Amphotericin

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18
Q

The ototoxic and nephrotoxic effects of aminoglycosides are experienced under what conditions? (Give 4)

A

If therapy is >5 days
In higher doses
In elderly
In patients with renal impairment

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19
Q

Penicillin is used in combination with aminoglycosides for the treatment of what infection?

A

Enterococcal endocarditis

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20
Q

Aminoglycosides are commonly used against gram-negative enteric bacteria. What two conditions highly recommend its use?

A

If bacteria is drug resistant and suspicion of sepsis

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21
Q

What is the mode of administration of Streptomycin?

A

IM

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22
Q

A pregnant female had Mycobacterium tuberculosis infection while pregnant and was treated with antibiotics. The patient suddenly experienced vertigo and loss of balance which was the result of the drug taken. The woman then gave birth to a deaf infant. What drug is most likely to cause this disability?

A

Streptomycin

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23
Q

Which bacteria is Streptomycin isolated from?

A

Streptomyces griseus

24
Q

In nontuberculous infections (plague, tularemia, brucellosis), streptomycin is used in combination with what drug?

A

Tetracycline

25
Q

Which of the following among the MOA of aminoglycosides is TRUE?
A. Reversible inhibitors of protein synthesis
B. Irreversible inhibitors of protein synthesis
C. Inhibit bacterial cell wall synthesis
D. None of the above

A

B

26
Q

What is the antidote for the curare-like effect of aminoglycoside overdose?

A

Calcium gluconate or Neostigmine

27
Q

From what organism is gentamicin isolated?

A

Micromonospora purpurea

28
Q

TRUE or FALSE: Gentamicin is effective on both gram positive and gram negative anaerobes

A

FALSE. NO ACTIVITY AGAINST ANAEROBES

29
Q

What two organisms are highly resistant to gentamicin?

A

Streptococci and Eterococci

30
Q

What group of antibiotics is used in combination with gentamicin for the treatment of gram positive endocarditis?

A

Beta lactams

31
Q

Gentamicin is used for severe infections by gram negative in what mode of administration? Give the dosage

A

IM/IV @ 5-6mg/kg/d or in equally divided doses at 3 times a day

32
Q

TRUE or FALSE: Gentamicin is ototoxic which is reversible and nephrotoxic but irreversible

A

FALSE. IRREVESIBLE ANG OTOTOXICITT HINDI NEPHROTOXICITY

33
Q

TRUE or FALSE: Gentamicin also comes in topical and intrathecal adminisitration. The latter is not recommended since it is highly toxic.

A

TRUE

34
Q

TRUE or FALSE: Tobramycin is similar to gentamicin but is more effevtive against E. faecium

A

FALSE. RESISTANT ANG E. FAECIUM SA TOBRAMYCIN

35
Q

Tobramycin is highly effective against P. aeruginosa. What is the mode of administration and the dosage against P. aeruginosa infection complicating CF?

A

300mg in 5ml (inhalation)

36
Q

What is the semisynthetic derivative of Kanamycin?

A

Amikacin

37
Q

Among the aminoglycosides, which i the most ototoxic?

A

Neomycin, Kanamycin, Amikacin

38
Q

What is the target peak serum concentration for amikacin every 12hrs?

A

20-40 mcg/ml

39
Q

What are the most vestibulotoxic aminoglycosides?

A

Streptomycin and Gentamicin

40
Q

TRUE or FALSE: Mycobacterium that are MDR, are highly resistant to amikacin

A

FALSE. SUSCEPTIBLE SILA AT 7.5-15mg/kg/d

41
Q

A patient with visceral leishmaniasis indergoes antibiotic treatment. His creatinine clearance is 50ml/min and he suddenly develops hearing loss. What antiobiotic was most likely administrated?

A

Paramomycin

42
Q

what is the topical form of neomycin which is only limited to 15mg/kg/d?

A

Neomycin-polymyxin-bacitracin formula

43
Q

Neomycin is administered PO at 1g every 6-8hrs for 1-2days for what application? What other drug is used in combination with neomycin for this application?

A

For elective bowel surgery in combi with erythromycin (1g)

44
Q

Which among the aminoglycosides is the most nephrotoxic?

A

Neomycin, Tobramycin, Gentamicin

45
Q

Which among the aminoglycosides is too toxic for parental use and is only available in topical and oral use?

A

Neomycin (toxic for parenteral use) and Kanamycin

46
Q

What organisms are highly resistant to Neomycin and Kanamycin?

A

P. aeruginosa and streptococci

47
Q

What is the mode of administration of the semisynthetic derivative of Kanamycin?

A

IV (Amikacin)

48
Q

This aminoglycoside has an additional ethyl group at 1-amino, 2-deoxystreptamine ring?

A

Netilmicin

49
Q

What is the function of the additional ethyl group in netilmicin?

A

Protects it from enzymatic degradation at ring III (3-amino) and ring II (2-hydroxyl)

50
Q

A patient with an anaerobic infection was prescribed with Gentamycin at 2-10mcg/ml. Which of the ff will be the effect of the drug to the patient?
A. Deafness
B. Creatinine clearance

A

D

No effect because gentamicin has no activity against anaerobes. Plus it is highly nephrotoxic and vestibulotoxic

51
Q

45yo man with no medical history was admitted to the ICU 10d ago after suffering 3rd degree burns.
temp=39.5C, WBC=20,000per cubic mm, BP=86/50, wt=70kg, creat clear=90ml/min
ICU attending physician is concerned about sepsis and decides to treat with empiric combi therapy (incldg TOBRAMICIN) directed against Pesudomonas. How should tobramicin be dosed?

A

350-490mg once daily (normal renal fxn, if with renal impairment 117-163mg every 8hrs)

[IM 5-7mg/kg/d]

52
Q

45yo man with no medical history was admitted to the ICU 10d ago after suffering 3rd degree burns.
temp=39.5C, WBC=20,000per cubic mm, BP=86/50, wt=70kg, creat clear=90ml/min
ICU attending physician is concerned about sepsis and decides to treat with empiric combi therapy (incldg TOBRAMICIN) directed against Pesudomonas. Peak level and trough level.of tobramycin must be maintained in what values?

A

Peak level= 5-10mcg/ml

Trough level

53
Q

Neomycin at 1g every 6-8hrs is precribed to supress coliform flora together with reduced protein intake in patients with hepatic encephalopathy. What is the rationale behind this?

A

To reduce ammonia production

54
Q

This is an aminocyclitol antibiotic lacking an amino sugar and glycosidix bonds.

A

Spectinomycin

55
Q

Spectinomycin is used solely in what infection?

A

Drug resistant gonorrhea in penicillin allergic patient

Pharmacology (12 decks)

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