Antimicrobials: Aminoglycosides

Question 1

Aminoglycoside drugs

4

Answer 1

Gentamicin
tobramycin
amikacin
streptomycin

Question 2

how are aminoglycosides given?

Answer 2

IV. Poor PO absorption.

Question 3

ahminoglycosides are likely the most ___ abx

Answer 3

toxic

Question 4

MoA Aminoglycosides (2)

Answer 4

bind to 30S ribosomal subunit, decreasing protein synthesis.

increases misreading of mRNA, which is bacteriocidal

Question 5

blackbox warning: aminoglycosides

Answer 5

nephrotoxic
ototoxic
*NEED drug levels because these drugs are very toxic

Question 6

Activity of aminoglycosides

Answer 6

• aerobic gram negatives, including pseudomonas
• very active against gram negative aerobes
• NO anaerobic of gram positive activity.

Question 7

ahminoglycosides and cell wall active B-lactams like PCN, amp, vancomycin:

Answer 7

synergistic, may make gram pos drugs work better by weakening them (cant kill them)

Question 8

example of a synergistic combo ft aminoglycosides

Answer 8

gentamicin and ampicillin

Question 9

ahminoglycosides and vanco

Answer 9

synergistic against MSSA, MRSA, enterococcus, and pseudomonas.

Question 10

distribution of aminoglycosides (good and bad)

Answer 10

vascular and interstitial spaces of most tissues
good penetration to urine

poor penetration to lungs (unless inhaled), CSF, biliary.

Question 11

nephrotoxicity of aminoglycosides

Answer 11

injury or death of proximal or renal tubule cells, dec’d GFR

reversible

Question 12

ototoxicity of aminoglycosides

Answer 12

may be unilateral or bilateral

pts may complain of tinnitus or fullness of the ears
can cause conversational hearing loss
irreversible

Question 13

preventing nephrotoxicity and ototoxicity in aminoglycosides

Answer 13

dose with ideal or adjusted body weight

Question 14

elimination of ahminoglycosides

Answer 14

100% by kidneys

Question 15

half life of aminoglycosides

Answer 15

1 - 72 hours or more

depending on renal function

Question 16

dose adjustment for aminoglycosides

Answer 16

for decreased renal function

may need pharmacokinetic team to calculate perfect dose

Question 17

gentamicin or tobramycin troughs should be

Answer 17

< 2 mcg/L

Question 18

amikacin trough

Answer 18

< 10 mcg / L

Question 19

amino glycoside monitoring

Answer 19

C&S
CBC
RFT
Hearing
troughs

Question 20

pregnancy/breastmilk category of aminoglycosides

Answer 20

D

small amounts excreted in milk

Question 21

pediatric dosing of aminoglycosides

Answer 21

dose by mg/kg and know that these doses change frequently especially in neonates