Aminoglycosides Flashcards

1
Q

Give 4 examples of aminoglycosides

A
  • Gentamicin
  • Amikacin
  • Neomycin
  • Tobramycin
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2
Q

What is the mechanism of action of aminoglycosides?

A

Inhibit bacterial synthesis by irreversibly binding to the 30d subunit on the ribosome, preventing elongation of the bacterial protein chain

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3
Q

Are aminoglycosides broad spectrum or narrow spectrum?

A

Narrow

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4
Q

What bacteria are aminoglycosides effective against?

A

Gram +ve and some -ve bacteria

Not effective against anaerobes

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5
Q

What are the routes of delivery of aminoglycosides?

A
  • IV
  • I’m
  • Topical, e.g. Eye/ear drops
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6
Q

Why are aminoglycosides not given orally?

A

They are not well-absorbed in the gut

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7
Q

How long can you give parenteral antibiotic treatment for?

A

Avoid giving for more than 7 days

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8
Q

What are the indications for aminoglycosides?

A
  • Meningitis
  • Sepsis
  • Hospital acquired pneumonia
  • Biliary tract infections
  • Acute pyelonephritis and prostatitis
  • Endocarditis
  • Pseudomonas aeruginosa infections
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9
Q

What are the contraindications to aminoglycosides?

A
  • Myasthenia gravis

- Grommets in situ (for intra-aural use)

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10
Q

What are the cautions for aminoglycosides?

A
  • Severe renal impairment or renal failure

- 2nd and 3rd trimester of pregnancy

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11
Q

Why should aminoglycosides not be given in patients with myasthenia gravis?

A

They are known to impair neuromuscular transmission

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12
Q

Why should caution be taken when using aminoglycosides in severe renal impairment or renal failure?

A

Aminoglycosides undergo renal excretion

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13
Q

Why should aminoglycoside use be avoided in the 2nd and 3rd trimester?

A

Due to risk of causing auditory or vestibular nerve damage in infant

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14
Q

What monitoring is required with aminoglycosides?

A
  • Check renal function at baseline and during review appointments as per local guidelines
  • Serum aminoglycoside levels should be monitored as per local protocols
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15
Q

Why is it important to check renal function before starting aminoglycosides?

A

Avoids excessive or sub-therapeutic treatment

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16
Q

What are the target serum gentamicin levels?

A

5-12mg/L at peak, <2mg/L trough

17
Q

What might interact with aminoglycosides?

A
  • Loop diuretics
  • Vancomycin
  • NSAIDs
  • Cephalosporins
  • Ciclosporins
  • Aciclovir
  • Cisplatin
  • Trimethoprim
  • Digoxin
18
Q

What might happen if you give loop diuretics with aminoglycosides?

A

Increased risk of ototoxicity

19
Q

What might happen if you give vancomycin with aminoglycosides?

A

Increased risk of otoxicity

20
Q

What might happen if you give NSAIDs with aminoglycosides?

A

Increased risk of nephrotoxicity

21
Q

What might happen if you give cephalosporins with aminoglycosides?

A

Increased risk of nephrotoxicity

22
Q

What might happen if you give ciclosporins with aminoglycosides?

A

Increased risk of nephrotoxicity

23
Q

What might happen if you give cisplatin with aminoglycosides?

A

Increased risk of nephrotoxicity

24
Q

What might happen if you give aciclovir with aminoglycosides?

A

Increased risk of nephrotoxicity

25
Q

What might happen if you give trimethoprim with aminoglycosides?

A

Increased risk of nephrotoxicity

26
Q

What might happen if you give digoxin with aminoglycosides?

A

Potential increase in serum digoxin concentration

27
Q

What are the side effects of aminoglycosides?

A
  • Antibiotic associated colitis
  • Electrolyte disturbances
  • Hypocalcaemia
  • Hypokalaemia
  • Hypomagnesaemia
  • Nausea
  • Peripheral neuropathy
  • Nephrotoxicity
  • Ototoxicity
  • Neurotoxicity
28
Q

What counselling needs to be given to patients on aminoglycosides?

A
  • Complete antibiotic course

- Report problems with hearing or balance and stop drug

29
Q

What counselling needs to be given regarding hearing and balance to patients on aminoglycosides?

A

Aminoglycosides may cause ototoxicity, hence patients should be advised to stop taking drug if hearing loss, tinnitus, or problems with balance develop, and to inform their doctor of these changes