Pharmacology: Aminoglycosides

What kind of agent are aminoglycosides?
Bactericidal

What kind of infection do Aminoglycosides treat?
Gram-negative microorganisms

What is the prototype for aminoglycosides?
Gentamicin (Garamycin)

Why do patients receive Gentamicin?
Systemic infections

When given orally, is Gentamicin absorbed properly?
No. Gentamicin is absorbed poorly from the GI tract.

Given orally will exert local effects in the GI tract.

Where does Gentamicin have the highest concentration?
Proximal renal tubule of the kidney

Name two things to watch out for with patients on Gentamicin
Nephrotoxicity
Ototoxicity

What is gentamicin used to treat?
Septicemia
Respiratory tract infections
Urinary tract infections
intra-abdominal infections
Osteomyelitis

Why is individualization of dose in gentamicin extremely critical in children and adult?
Low therapeutic index

How long until the risk of toxicity increases in gentamicin?
1 week use

Gentamicin can be used in smaller doses in treatment of urinary tract infection because…
Aminoglycosides reach high concentrations in the urine

BLACK BOX WARNING for Gentamicin
These drugs are nephrotoxic and ototoxic and must be used very cautiously in presence of renal impairment

Nephrotoxicity in Gentamicin
Reversible

Ototoxicity in gentamicin
May not be reversible

There are two major dosing schedule used for Gentamicin. What are they?
ODA (once-daily aminoglycosides)
Multiple daily doses (conventional dosing)

What does concentration-dependent bactericidal effects mean?
Means that a large dose of aminoglycosides, with high peak serum concentrations, kills more microorganisms.

What does post-antibiotic effect mean?
Aminoglycosides continue killing microorganisms even at low serum concentrations.

What kind of drug increases the effect of Gentamicin?
Loop diuretics – Increase risk of nephrotoxicity and ototoxicity

Drug that decreases the effects of gentamicin
Penicillins – Decrease serum concentrations

Can you mix penicillins and aminoglycosides in the same IV solution/syringe?
No. Penicillin will cancel the aminoglycosides.

Which aminoglycoside is given orally to prepare the GI tract for surgery?
Neomycin

Why is Amikacin, a form of aminoglycoside, given?
Given IV
Broader spectrum
Resists degradation by most enzymes that inactivate gentamicin and tobramycin

What is streptomycin, an aminoglycoside, used for?
Treatment of multidrug-resistant TB

Why is tobramycin, an aminoglycoside, given?
More active against Pseudomonas organisms
Used with other antibiotics for septicemia and infections of burn wounds, other soft tissues, bone, UT, and CNS

Why is Kanamycin (Kantrex), an aminoglycoside, given?
Used to decrease bowel organisms before surgery
Treat hepatic coma
Treat multi-drug resistant TB

If patient states ringing in ears, what would the nurse do?
Stop the infusion of aminoglycoside
Draw lab
Call physician

Why is this drug cautioned use in patients with myasthenia gravis?
Increased muscle weakness

Aminoglycosides gentamicin, streptomycin, tobramycin, neomycin, kanamycin, amikacin (BE CAREFUL WITH THESE “mycins”. They’re not macrolides) Aminoglycosides – gram (-) Bactericidal Aminoglycosides *treat aerobic bacteria such as escherichia coli and klebsiella species *they inhibit protein synthesis in bacteria and compromise the …

Therapeutic uses of gentamicin treats serious infections caused by G-, systemic UTI that started un urinary tract Mode of Action for gentamicin bactericidal; inhibition of bacterial protein synthesis, destroy MO and may cause miscoding. WE WILL WRITE A CUSTOM ESSAY …

Azithromycin Drug Type Trade Name -Drug Type: antibacterial macrolide -Trade Name: Zithromax, AzaSite -Power point: Erythromycin (E-Mycin) Clarithromycin (Biaxin) Azithromycin (Zithromax) Azithromycin: Macrolide Action -Binds to 50S ribosomal subunits and inhibits protein synthesis -Broad spectrum -Treats most gram-positive, some gram-negative …

Aminoglycosides Class Name an antibiotic class that you would worry about nephrotoxicity and ototoxicity? Sulfonamides, Tetracyclines, Fluoroquinolones Name 3 antibiotic classes that have an the adverse effect, photosensitivity? WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR …

Macrolides: Erythromycin Binds to 50S ribosomal subunits and inhibits protein synthesis Broad spectrum Most gram +, some gram – bacteria Bacteriostatic: low to moderate doses Bactericidal: high doses Route Oral, IV Uses Erythromycin Moderate-to-severe infections Respiratory, GI tract Skin, soft …

The nurse caring for a patient who will receive penicillin to treat an infection asks the patient about previous drug reactions. The patient reports having had a rash when taking amoxicillin (Amoxil). The nurse will contact the provider to a. …

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