Aminoglycosides: Lethal Inhibitors of Protein Synthesis Flashcards
explain the mechanism of action of the aminoglycosides.
MOA: disrupt bacterial protein synthesis by binding to the 30S ribosomal subunit causing inhibition of protein synthesis, premature termination of protein synthesis, and production of abnormal proteins.
bactericidal, cell death is concentration dependent.
state the major therapeutic use of aminoglycosides, absorption, distribution, and adverse effects.
therapeutic use: parenteral therapy for serious infections due to aerobic gram-negative bacilli. Primary target organisms are P. aeruginosa and Enterobacteriaceae (E. Coli, Klebsiella, Serratia, P. mirabilis.
absorption: very little of an oral dose is absorbed due to polycations. Hence for treatment of systemic infections, aminoglycosides must be given parenterally.
distribution: limited largely to extracellular fluid. Cannot treat meningitis in adults–cannot enter into the cerebrospinal fluid.
can induce nephrotoxicity.
can be ototoxic
aminoglycosides can cross the placenta and may be toxic to the fetus.
contrast the once daily dosing of gentamicin with divided doses.
Single daily dosing of aminoglycosides is possible because of their rapid concentration-dependent killing and post-antibiotic effect and has the potential for decreased toxicity.
the best I found
regarding nursing implications for aminoglycosides describe how to identify high risk patients, how to administer, and how to recognize adverse effects.
Aminoglycosides must be given parenterally (IV-IM) to treat systemic infections.
instruct patients to report symptoms of ototoxicity (tinnitus, high-frequency hearing loss, persistent headache, nausea, unsteadiness dizziness, vertigo).
monitor serum creatinine and BUN for nephrotoxicity. If oliguria or anuria develops withhold the aminoglycoside and notify the prescriber.
carefully observe patients with myasthenia gravis and patients receiving skeletal muscle relaxants or general anesthetics.
increased nephrotoxicity with acetaminophen B, cephalosporins, polymyxins, vanocmycin, cyclosporine, NSAIDs. Increased ototoxicity may occur with ethacrynic acid.
