Renal Drugs Flashcards
Name 3 aminoglycosides
- Neomycin
- Gentamicin
- Amikacin
When are aminoglycosides used for in paticular
Gram negative aerobes
What is the MOA of aminoglycosides
Binds to 30s ribosomal subunit to inhibit protein synthesis
What organisms are innately resistant to aminoglycosides and how
Streptococci and anaerobes.
As aminoglycosides rely on oxygen-dependent transporters to enter cells which are absent in the above
What are the main side effects of aminoglycosides
Nephrotoxic
Ototoxic
What nephrotoxic effect do aminoglycosides have
Acute tubular necrosis
How does ototoxicity present
Vertigo
SNHL
Tinnitus
In which 3 patient groups should aminoglycosides be prescribed with care due to enhanced ototoxic effects
- Elderly
- Neonates
- Renal impairment
In which group should aminoglycosides be prescribed and why
Myasthenia gravis - due to altering transmission ad neuromuscular junction
What 2 drugs increases ototoxicity of aminoglycosides
Loop diuretics
Vancomycin
What 3 drugs enhanced nephrotoxicity of aminoglycosides
Platinum-based chemotherapy
Ciclosporin
Cephalosporin
Vancomycin
Explain route of delivery of aminoglcyosides
They are highly polarised and therefore do not cross lipid membranes and cannot be absorbed by the gut
What rate should aminoglycosides be given and why
Slow infusion - stops ototoxic effects
What should be assessed before giving aminoglycosides
Renal function
What is monitored on aminoglycosides
Plasma concentration (18-24h after first dose)
