[3S] Aminoglycosides & Spectinomycin

Question 1

Aminoglycosides Excretion

Answer 1

Urine, with small portions of oral administrations excreted through feces

Question 2

PKINETICS

● Limited tissue penetration (esp. BBB/eyes)
● Poorly absorbed orally
● Excretion is directly proportional to creatine clearance

Answer 2

All aminoglycosides

Question 3

Gentamicin ROA

Answer 3

IV, IM, Topical, Ocular, Intrathecal

Question 4

MOA

● Bactericidal (irreversible)
● Passive via porins
● Active via oxygen-dependent process
● Bind to 30S:
o Blocks initiation complex
o Misread mRNA
o Inhibit mRNA translocation

Answer 4

All aminoglycosides & spectinomycin

Question 5

CLINICAL APPLICATIONS

● Gr(+) bacteria
● Gr(-) bacteria
o E. coli, Klebsiella, Providencia, Serratia, Enterobacter, Proteus, Pseudomonas
● Staphylococci
● E. faecialis

Answer 5

Gentamicin & Tobramycin

Question 6

CLINICAL APPLICATIONS

More active against Serratia

Answer 6

Gentamicin

Question 7

Enhances the uptake of Gentamicin

Answer 7

Penicillin or Vancomycin

Question 8

CLINICAL APPLICATIONS

NO ACTIVITY against anaerobes

Answer 8

ALL except Plazo, Strepto, Specti

Question 9

TOXICITIES

● Nephrotoxicity
● Ototoxicity:
o Vestibular dysfunction
o Hearing loss

Answer 9

Gentamicin

Question 10

Tobramycin ROA

Answer 10

IV, IM, IH

Question 11

CLINICAL APPLICATIONS

More active against P. aeruginosa

Answer 11

Tobramycin

Question 12

CLINICAL APPLICATIONS

● Lower RTIs
● Cystic fibrosis
● Superficial eye infections (ointments and drops)

Answer 12

Tobramycin

Question 13

CLINICAL APPLICATIONS

NO ACTIVITY against anaerobes AND E. faecium

Answer 13

Tobramycin

Question 14

TOXICITIES

● Ototoxic (rare)
● Nephrotoxic (rare)
● Neuromuscular blockade

Answer 14

Tobramycin

Question 15

Amikacin ROA

Answer 15

IV

Question 16

CLINICAL APPLICATIONS

● Gr(-) bacteria
o Proteus, Pseudomonas, Enterobacter, Serratia
● Resistant to tobramycin/gentamicin-inactivating enzymes

Answer 16

Amikacin

Question 17

CLINICAL APPLICATIONS

MDR and streptomycin-resistant TB

Answer 17

Amikacin

Question 18

TOXICITIES

● Ototoxicity (Auditory damage)
● Nephrotoxicity
● Neuromuscular blockade

Answer 18

Amikacin

Question 19

Netilmicin ROA

Answer 19

IV, IM, Topical, Ocular, Intrathecal, PO

Question 20

CLINICAL APPLICATIONS

● Gentamicin-resistant bacteria
● Tobramicin-resistant bacteria

Answer 20

Netilmicin

Question 21

Can be interchangeable with gentamicin and tobramycin

Answer 21

Netilmicin

Question 22

TOXICITIES

● Ototoxicity and nephrotoxicity
● Neuromuscular blockade

Answer 22

Netilmicin & Paromomycin

Question 23

Neomycin ROA

Answer 23

PO, Topical

Question 24

CLINICAL APPLICATIONS

● Gr(+) bacteria
● Gr(-) bacteria
● Some mycobacteria

Answer 24

Neomycin

Question 25

CLINICAL APPLICATIONS ● Infected skin lesions ● Elective bowel surgery ● Hepatic encelopathy

Answer 25

Neomycin

Question 26

TOXICITIES ● Ototoxicity (Auditory damage) ● Nephrotoxicity ● Neuromuscular blockade ● Irritation

Answer 26

Neomycin

Question 27

CLINICAL APPLICATIONS NO ACTIVITY against P. aeruginosa, Streptococci + anaerobes

Answer 27

Neomycin, Kanamycin, Paromomycin

Question 28

TOXICITIES Allergic reactions (contact dermatitis)

Answer 28

Neomycin

Question 29

Kanamycin ROA

Answer 29

PO, Topical, IV, IM

Question 30

CLINICAL APPLICATIONS MDR-TB (but amikacin is preferred)

Answer 30

Kanamycin

Question 31

TOXICITIES ● Ototoxicity (auditory damage) ● Nephrotoxicity ● Neuromuscular blockade ● [For MDR-TB] Cross-resistance with amikacin

Answer 31

Kanamycin

Question 32

Paromomycin ROA

Answer 32

PO, Topical, IV, IM

Question 33

CLINICAL APPLICATIONS ● Visceral leishmaniasis ● Cutaneous leishmaniasis ● E. histolytica infections

Answer 33

Paromomycin

Question 34

Plazomicin ROA

Answer 34

IV

Question 35

CLINICAL APPLICATIONS Gr(-) bacilli ● Enterobacteriaceae ● Staphylococci ● cUTIs

Answer 35

Plazomicin

Question 36

TOXICITIES ● Possibly causes renal-related adverse effects ● Neuromuscular blockade

Answer 36

Plazomicin

Question 37

Streptomyces griseus

Answer 37

Streptomycin

Question 38

Streptomycin ROA

Answer 38

IM/IV

Question 39

CLINICAL APPLICATIONS ● MTB ● Viridans streptococci

Answer 39

Streptomycin

Question 40

CLINICAL APPLICATIONS ● Extracellular tubercle bacilli (second-line TB) ● TB (second-line) Plague Tularemia Brucellosis

Answer 40

Streptomycin

Question 41

CLINICAL APPLICATIONS: Penicillin: o Enterococcal endocarditis o Viridans o Streptococcal endocarditis

Answer 41

Streptomycin

Question 42

TOXICITIES ● Ototoxicity (vestibulotoxic) ● Nephrotoxicity ● Hypersensitivity ● Neuromuscular blockade

Answer 42

Streptomycin

Question 43

Spectinomycin ROA

Answer 43

IM

Question 44

CLINICAL APPLICATIONS ● Drug-resistant gonorrhea ● Penicillin-allergic gonorrhea

Answer 44

Spectinomycin

Question 45

CLINICAL APPLICATIONS NOT RECOMMENDED for pharyngeal gonococcal infections

Answer 45

Spectinomycin

Question 46

TOXICITIES ● Pain at injection site ● Fever ● Nausea

Answer 46

Spectinomycin