Infectious Diseases I: Aminoglycosides

Question 1

AG MOA

Answer 1

Bind to ribosome and inhibit protein synthesis of bacterial cells

Question 2

AG have what type of killing

Answer 2

concentration-dependent

Question 3

AG have a post-antibiotic effect (t/f)

Answer 3

True

Continued suppression of bacterial growth when antibiotic levels fall below MIC

Question 4

Extended interval dosing is beneficial bc…

Answer 4

it decr nephrotoxitiy and cost

has NOT shown to be clinically superior to traditional dosing

Question 5

AG coverage

Answer 5

mostly gram - (includ. pseudomonas)

used for synergy for treating gram + cocci (strep, entercoccus)

Question 6

AG side effects

Answer 6

nephrotoxicty
ototoxicity
vestibular toxicity (balance issues)

Question 7

If a pt is underweight use ____ to dose AGs

Answer 7

actual body weight

Question 8

If a pt is overweight use ____ to dose AGs

Answer 8

adjusted body weight

Question 9

Traditional dose of gentamicin and tobramycin

Answer 9

1-2.5 mg/kg/dose
lower for synergy w/ gram +
higher for gram - infection

Question 10

Extended interval dosing for gent/tobra

Answer 10

4-7 mg/kg/dose

Question 11

Dosing for amikacin

Answer 11

5-7 mg/kg/dose

Question 12

Contraindications for using extended interval dosing

Answer 12

pregnancy
ascites
burns
CF
CRcl < 30
ESRD

Question 13

What nomogram is commonly used for extended interval dosing?

Answer 13

Hartford nomogram

determines dosing interval based on concentration of random level

Question 14

Target peak concentrations for gent/tobra

Answer 14

5-10 mcg/ml

Question 15

Target trough conc for gent/tobra

Answer 15

< 2 mcg/ml

Question 16

Target peak and trough conc for synergy dosing of gent

Answer 16

peak: 3-4 mcg/ml
trough: < 1 mch/ml

Question 17

Target peak conc for amikacin

Answer 17

20-30 mcg/ml

Question 18

target trough conc for amikacin

Answer 18

< 5 mcg/ml