13. Aminoglycosides

Question 1

Aminoglycosides

Answer 1

Streptomycin 
Neomycin 
Gentamicin 
Tobramycin 
Amikacin

Question 2

Streptomycin 
Neomycin 
Gentamicin 
Tobramycin 
Amikacin

Answer 2

Protein synthesis inhibitor S30 subunit - Irreversible inhibition (inhibits tRNA binding mRNA complex)
Bactericidal
Concentration dependant (Cmax : MIC 8-10:1)
Long PAE
Polar
Transported into the cell by an oxygen dependent process (do not act against anarobes)

Spectrum: G-ive aerobes, Pseudomonas, klebsiella, enterobacter
Clinical use: Monotherapy: UTI | in combination (+𝛽 lactams): Enterococcus faecium and faecalis infective endocarditis
Mechanism of resistance: Efflux pump | decreased uptake | enzymes

Administration: IV (neomycin only topical)
Intrathecally in CNS infection
Dose: Based on lean body mass
Distribution: Poor tissue penetration, low CNS concentration ,cross placental
Excretion: Renal (glomerular filtration)

Adverse effect: Nephrotoxicity | Ototoxicity (vestibular / cochlear), deafness may be irreversible | Neuromuscular blockade (neostigmine can reverse) | Contact dermatitis

Question 3

neomycin can be given

Answer 3

only topical

Question 4

Neuromuscular blockade adverse effect can be treated with …

Answer 4

neostigmine

Question 5

Streptomycin

Answer 5

Aminoglycoside
Bactericidal, toxic (oto and nephro), acts against extracellular mycobacteria
border line treatment in mycobacteria