Aminoglycosides, Monobactams and Carbapenem

Question 1

What are the two common monobactams and how are they administered?

Answer 1

aztreonam: parenteral
Trigemonam: orally

Question 2

Spectrum for monobactams

Answer 2

Gram negative and pseudomonas

CIA

Question 3

Indications for monobactams

Answer 3

septicaemia
meningitis
peritonitis
E.coli multiresistant, Uti

Question 4

Common carabapenems

Answer 4

Imiperem

Meroperem

Question 5

what can we combine imiperem with to increase the half life, and what is the half life normally?

Answer 5

1-2 h normally

if we use cilastatin, we can increase the halflife as it will inhibit dihydropeptidase

Question 6

What does the amount of amino groups mean for aminoglycosides

Answer 6

more amino groups means more accumulation and especcially in ear and kidney (phosphatidili inositol)

Question 7

oral absorption of aminoglycosides?

Answer 7

bad - hydrophilic

excreted by the kidney without metabolic change

Question 8

which aminoglycosides are the natural ones, and what is the name of the fungi?

Answer 8

streptomycin
neomycin
spectinomycin - aminocyclitol
kanamycin
tobramycin

by streptomyces spp

Question 9

semisynthetic aminoglycoside and fungi

Answer 9

amikacin

streptomyces spp

Question 10

synthetic aminoglycoside

Answer 10

gentamicin

micromonospora spp

Question 11

mechanism of action of aminoglycosides

Answer 11

30s ribosomal ubuint - produces false proteins

needs oxygen and energy to be taken up

RNA structure damage

Question 12

mode of action - aminoglycosides

Answer 12

bactericidal (spectinomyocin is bacteriostatic)
concnetration dependent
PAE

Question 13

spectrum of aminoglycosides

Answer 13

gram negativ aerobic and staphylococcus spp

Question 14

Resistance of aminoglycosides

Answer 14

Ab ovo: anaerobic bacteria and E.coli is spreading

cross resistance, one way

Question 15

resistance mechanisms of bacteria towards aminoglycosides

Answer 15

plasmids
altering enxymes: acetylation, adenylation
reduced permeability: active transport

Question 16

aminoglycosides: absorption

Answer 16

PO or parenteral

intramammary, intrauterine or into abscesses

Question 17

aminoglycosides: distribution

Answer 17

not very good - hydrophilic
used to treat meningitis - BBB
cats are sensitive, dont treat cts abscesses

Question 18

aminoglycoside accumulation

Answer 18

in kidney cortec and ear

Question 19

aminoglycosides toxicity

Answer 19

one of the most toxic AB. neomycin most toxic

Question 20

predisposing factors: aminoglycosides

Answer 20

kidney problems
hydration state
operation

Question 21

combining muscle relaxants and aminoglycosides?

Answer 21

dont do it: neuromuscular blockade (myosthenia grais like symptoms) Ach release is inhibitied

Question 22

aminoglycosides indications

Answer 22

respiratory infections
GI
UTI
mastitis 
dermatitis - topical
septicaemia - combination

Question 23

aminoglycoside antibiotic drugs

Answer 23

streptomycin
neomycin
gentamicin
spectinomycin
apramycin
tobramycin
amikacin

Question 24

good aminoglycosides against pseudomonas spp

Answer 24

amikasin
gentamycin
tobramycin

Question 25

streptomycin - use - indication - duration - application

Answer 25

``` Don’t use alone Used in combinations w/penicillins TTC Used against streptococcus, mastitis Duration is 86h IM or SC (intramammary) ```

Question 26

Neomycin - use - indication - synergist

Answer 26

``` Used alone Used in combinations w/penicillins – if it is life threathening, more potent effect Mastitis – topical Biosol – GI Parenteral – not frequently used Synergistic strepto + penicillin - Different bacteria is targeted - Penicillin – cell wall - Aminoglycoside – can be transported inside bacteria ```

Question 27

Gentamicin - use - application - indication

Answer 27

``` Alone w/ penicillin – CIA (amoxicillin) per os, parentera or topical mastitis UTI Ear, eye drops = topical GI – per os ```

Question 28

spectinomycin - mode of action - indications - use - application

Answer 28

Bacteriostatic Mycoplasma – good against it Used alone and in combination with lincomycin (anaerob + aerob) Per os and parenteral

Question 29

apramycin - species - application - indication

Answer 29

Bioavailability is better wit oral administration Swine Per os GI or respiratory

Question 30

tobramycin - info - application - indication

Answer 30

Most active Toxic Topical, parenteral Ear, eye

Question 31

amikacin - toxic? - ow long can it be used? - indications?

Answer 31

``` One of the most active Slightly toxic Parenteral Very safe, can be used for two weeks Good against MRSA, MRSP ```