Anti-infectives (Aminoglycosides)

Question 1

Mechanism of action (Aminoglycosides)

Answer 1

Binds to the 30s ribosomal subunit, inhibiting protein synthesis, including a prolonged post-antibiotic bacteriostatic effect.
Bactericidal action of bacterial cell wall results in rapid killing early in dosing interval and is prominent at high doses.
Synergistic effect when used alongside other antibiotics (i.e. flucloxacillin).

Question 2

Indications (Aminoglycosides)

Answer 2

Severe gram-negative infections (i.e. hospital acquired pneumonia).
Some severe gram positive infections (i.e. endocarditis).

Question 3

Side effects (Aminoglycosides)

Answer 3

Nephrotoxicity.

Ototoxicity.

Question 4

Important pharmacokinetics/pharmacodynamics (Aminoglycosides)

Answer 4

Give high initial dose to take advantage of rapid killing.
Leave long dosing interval to minimise toxicity.
Measure trough level to ensure gentamicin is not accumulating and only prescribe further doses once this is confirmed.
Try to limit use to approximately 3 days to minimise risk of side-effects.

Question 5

Patient information (Aminoglycosides)

Answer 5

Report any change to their hearing.

Risk of kidney damage so monitoring of drug levels and renal function tests are required.

Question 6

Example(s) of drug (Aminoglycosides)

Answer 6

Gentamicin