Aminoglycosides

Question 1

Aminoglycoside indications

Answer 1

severe sepsis, pyelonephritis, UTI, billiary, intra-abdominal sepsis, endocarditis

Question 2

Aminoglycoside infections

Answer 2

gram negative, pseudomonas auerginosa but not against streptococci and anaerobes

Question 3

Aminoglycosides MOA

Answer 3

Bind irreversibly to bacterial ribosomes and inhibit protein synthesis, bactericidal

Question 4

Aminoglycoside adverse effects

Answer 4

Nephrotoxicity, otoxicity,

Question 5

Aminoglycoside interactions

Answer 5

codynamic otoxicity with loop diuretic, codynamic nephrotoxicity with ciclosporin, platinum chemotherapy, cephalosporin, vancomycin

Question 6

Aminoglycoside examples

Answer 6

gentamicin, amikacin

Question 7

Aminoglycosides monitoring

Answer 7

For multiple daily dose regimen, one-hour (‘peak’) serum concentration should be 5–10 mg/litre; pre-dose (‘trough’) concentration should be less than 2 mg/litre.

For multiple daily dose regimen in endocarditis, one-hour (‘peak’) serum concentration should be 3–5 mg/litre; pre-dose (‘trough’) concentration should be less than 1 mg/litre. Serum-gentamicin concentration should be measured after 3 or 4 doses, then at least every 3 days and after a dose change (more frequently in renal impairment).

Question 8

Gentamicin MHRA warning

Answer 8

MHRA/CHM advice: potential for histamine-related adverse drug reactions with some batches (November 2017)

Question 9

Gentamicin contraindication

Answer 9

Myasthenia gravis, Ear issues