Aminoglycosides: Sulfonamides and Trimethoprim

Question 1

Aminoglycoside MOA? Important Considerations? Not used for

Answer 1

Disrupt protein synthesis, bactericidal
NOT ACTIVE AGAINST GRAM +ve pathogens
Used as combo with VANC or BETA LACTAME abx

Question 2

Examples of Aminoglycosides?

Answer 2

Gentamicin (GARAMYCIN)
poor CSF penetration, given IV

Question 3

Gentamicin A/e?

Answer 3

RENAL TOXICITY; reversible
OTOTOXICITY; irreversible (needs peak and tough if used for a prolong period of time)

Question 4

Gentamicin drug interactions?

Answer 4

DO NOT MIX WITH PENICILLINS!!!! Will inactive each other

Question 5

Tobramycin/Aztreonam is used for what?

Answer 5

Cystic Fibrosis via nebulization (minimal systemic risk) improving pulmonary fx

Question 6

Tobramycin/Aztreonam a/e?

Answer 6

Ringing in the ears CAN occur, not hearing loss though – tx is 28 on and 28 off

Question 7

Aminoglycosides considerations for pregnancy women?

Answer 7

CATEGORY D – can harm the fetus, bfing lacks in data

Question 8

Sulfonamide MOA?

Answer 8

Bacteriostatic, inhibits folate & tetrahydrofolic acid needed for production of DNA, RNA and proteins

Question 9

Sulfonamide spectrum coverage?

Answer 9

gram +ve (including MRSA), gram -ve, chlamydia

Question 10

Sulfonamides: Trimethoprim a/e?

Answer 10

Myelosuppression, be cautious with folate deficient patients,

HYPERKALEMIA (consider renal impairment a concern)

Question 11

Sulfonamides: Trimethoprim/Sulfamethoaxole A/e?

Answer 11

SJS, blood dyscarsias (same as low reds and whites), AVOID IN NEONATES, interacts with warfarn, phenytoin, and sulfonylureas by intensifying effects

Question 12

When would you use Trimethoprim/Sulfamethoaxole (Sulfonamide)?

Answer 12

Wide range gram +ve/-ve and for pneumonia, bronchitis, OM, UTIs