Ch 87: Aminoglycosides: Bactericidal Inhibitors of Protein Synthesis Flashcards

1
Q

The aminoglycosides are…

A

…narrow-spectrum antibiotics used primarily against aerobic gram-negative bacilli; they are bactericidal inhibitors of protein synthesis.

(p. 1050)

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2
Q

Why must aminoglycosides be administered parenterally?

A

These drugs are highly polar, and thus cannot be absorbed from the GI tract.

(p. 1050)

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3
Q

Which aminoglycosides are used most commonly?

A

gentamicin, tobramycin, and amikacin

p. 1050

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4
Q

What is the postantibiotic effect?

A

When bactericidal activity persists for several hours AFTER serum levels have dropped below the minimal bactericidal concentration.

(p. 1050)

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5
Q

Which of the aminoglycosides is least susceptible to inactivation by bacterial enzymes?

A

amikacin

p. 1050

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6
Q

Which key microorganisms are susceptible to aminoglycosides?

mnemonic

A
(think of KPEPS
Klebsiella pneumoniae
Pseudomonas aeruginosa
Escherichia coli
Proteus mirabilis
Serratia marcescens

(p. 1050)

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7
Q

Aminoglycosides are highly polar polycations. As a result….

A

…they are not absorbed from the GI tract, do not cross the blood-brain barrier, and are excreted rapidly by the kidneys.

(p. 1056)

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8
Q

Aminoglycosides can cause…

A

…irreversible injury to sensory cells of the inner ears, resulting in hearing loss and disturbed balance.

(p. 1056)

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9
Q

The risk of ototoxicity is related primarily to…

A

…persistently elevated trough drug levels, rather than to excessive peak levels.

(p. 1056)

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10
Q

Aminoglycosides are nephrotoxic, but…

A

…renal injury is usually reversible.

p. 1056

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11
Q

What is the risk of nephrotoxicity from aminoglycosides related to?

A

The total cumulative dose AND elevated trough levels.

p. 1056

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12
Q

Monitoring of serum levels when treating with aminoglycosides is common. Peak levels must be high enough to…
Trough levels must be low enough to…

A

…cause bacterial kill.

…minimize toxicity to the inner ears and kidneys.

(p. 1056)

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13
Q

The first sign of impending vestibular damage is…

A

…headache.

p. 1053

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14
Q

The first sign of impending cochlear damage is…

A

…high-pitched tinnitus (ringing in the ears).

p. 1053

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