SESSION 1 Flashcards
According to NICE guidelines, what is the preferred dosing regimen for Gentamicin?
Once daily dosing.
What is the recommended monitoring for patients receiving Gentamicin?
Serum creatinine
Serum aminoglycosides concentrations
Auditory and vestibular function
What is the maximum duration of Gentamicin therapy recommended by NICE?
7 days
Dont give for longer than 5 days without discussion with department of infection
Fill in the blank: Gentamicin should be dosed based on the patient’s _____________.
Ideal body weight (unless they are underweight!)
Which of the following is a potential side effect of Gentamicin therapy? A) Nausea B) Ototoxicity C) Rash D) Headache
B) Ototoxicity
What is the recommended route of administration for Gentamicin according to NICE?
Intravenous/IM or topical
Not absorbed well from the gut as its poorly lipid-soluble!
Fill in the blank: Gentamicin is primarily excreted by the _____________.
Kidneys.
Which of the following is a contraindication for Gentamicin therapy? A) Renal impairment B) Hypertension C) Diabetes D) Asthma
A) Renal impairment
What is the mechanism of action of Gentamicin?
Targets the bacterial 30s ribosomal subunit which inhibits normal ribosomal functioning and blocks bacterial protein synthesis = cell death
What class of antibiotic is gentamicin?
Aminoglycoside.
What is the recommended duration of Gentamicin therapy for serious infections?
7-10 days.
True or False: Gentamicin is safe to use in pregnant women.
False - small risk of auditory or vestibular nerve damage in the infant when aminoglycosides are used in the second and third trimesters of pregnancy
What is the primary concern when prescribing Gentamicin to elderly patients?
Risk of nephrotoxicity and ototoxicity.
Which of the following is a common indication for Gentamicin therapy? A) Urinary tract infections B) Influenza C) Malaria D) Tuberculosis
A) Urinary tract infections
What is the recommended dosing interval for Gentamicin in patients with normal renal function?
Once daily.
Which of the following is a common adverse effect of Gentamicin therapy? A) Diarrhea B) Hypertension C) Tinnitus D) Insomnia
C) Tinnitus
Aminoglycosides are ototoxic and this is usually irreversible - bear in mind its rare if <2 weeks of Tx
True or False: Gentamicin is effective against anaerobic bacteria.
False
This is because aminoglycosides require oxygen-dependant transport to enter the bacterial cell
What is the recommended peak serum level for Gentamicin therapy?
5-10 mg/L.
How does once-daily dosing work for gentamicin?
Gentamicin dose is given according to IBW (unless underweight then 7mg/kg). The serum levels are then monitored 6-14 hours after the start of infusion. The dose interval is then adjusted according to the Hartford nomogram
How does once-daily dosing work for gentamicin?
Gentamicin dose is given according to IBW (unless underweight then 7mg/kg). The serum levels are then monitored 6-14 hours after the start of infusion. The dose interval is then adjusted according to the Hartford nomogram
Dose of gentamicin?
5-7mg/kg if once-daily dosing
3-5mg/kg if multiple daily dose regimen
Absolute contraindication of aminoglycosides?
Myasthenia gravis - can induce a myasthenic crisis
How does gentamicin cause ototoxicity?
Irreversibly damages auditory or vestibular nerve damage
How does gentamicin cause nephrotoxicity?
In renal failure gentamicin accumulates and is preferentially taken up by proximal renal tubular cells where they accumulate to toxic levels and cause ATN