Aminoglycosides Flashcards
What are the indications for Amikacin
to treat gram negative bacteria resistant to gentamicin
What are the indications for gentamicin
endocarditis, penumonia, meningitis, septicaemia, pylonephritis
what are the indications for neomycin
bowel sterility before surgery
what are the indications for streptomycin
reserved for TB
What are aminoglycosides mode of action?
inhibits protein synthesis
Bacteriocidal
What bacteria are they active against?
Gram negative bacteria such as pseudomonas, enterobacter, tuberculosis
and gram postive bacteria
What are the contraindications or cautions associated with aminoglycosides
Myasthenia gravis -eyes are contraindicated as it causes ototoxicity
Careful dosage as risk of auditory disorders
Avoid in patients with CrCL less than 20 ml./min, endocarditis, limb amputation or pregnancy
When should you monitor levels
in elderly, obesity, cycstic fibrosis, pregnant women and when high doses are given
Whats the target concentration for gentamicin in once daily dosing?
Peak level 5 - 10 mg/L
Trough level <1mg /L
Whats the target concentration for gentamicin for multiple daily dosing or in endocarditis?
peak 3-5 mg/L
Trough <1mg/L
What is streptomycin target concentration?
peak 15 to 40mg/L
Trough <5mg/L
What is tobramycin target concentration?
peak <10mg/L
Trough < 2mg/L
What are the adverse reactions with aminoglycosides?
Irreversible ototoxicity, nephrotoxicity, hypocalcaemia, hypokalaemia, hypomagnesemia, antibiotic associated colitis, skin reactions.
What should you do if there are high plasma serum concentrations?
The dose should be reduced and the interval between doses should be increased due to a risk of ototoxicity and nephrotoxicity.
Can you take aminoglycosides in pregnancy?
No due to the risk of auditory or vestibular nerve damage
