Sketchy Pharm: Aminoglycosides Flashcards
Considering their mechanism, what is unique about the aminoglycosides?
They are bactericidal, even though they inhibit bacterial ribosomes.
How do aminoglycosides work?
Aminoglycosides bind to the 30S subunit and cause misreading of mRNA.
(This is represented by the sai-wielding assassin who is hanging from the minute hand of the clock tower which is pointed at the 30-second mark; also, the translator he has assassinated is smearing the ink of the Kanji translation, symbolizing misread mRNA.)
Aminoglycosides are effective against which bacteria?
Aerobic Gram-negative rods
Think of the red brick wall that looks like Gram-negative bacilli.
What combination therapy is often used when treating someone with aminoglycosides?
Many aminoglycosides cannot penetrate the outer wall of Gram-negative bacteria, so beta-lactams or other cell-wall inhibitors are frequently used in combination to allow aminoglycosides to enter cells.
(Think of the assassins using beta-lactam bombs to break through the outer brick wall around the town square. Also, to emphasize the aerobic limitation, one of the assassins is using a bellows to stoke the fire.)
What routes of administration can be used with aminoglycosides?
IV only (like the ninja suspended from the IVY vine on the clock tower)
Note: like vancomycin, though, aminoglycosides can be used to kill intestinal bacteria if taken orally. (This is represented by the neomycin-ninja and the paromycin pair-of-mice sneaking into the colon-shaped tunnel with a scalpel (the scalpel represents prophylaxis in surgery)
Which infections are represented by the assassin in the tree?
Tularemia (from Francisella infections) and plague (from Yersinia pestis)
(Think of the bunny suit and squirrels to help you remember these zoonotic infections.)
Tobramycin and gentamicin are often used for __________________.
treatment of nosocomial pneumonia or UTIs from Gram-negative rods such as Pseudomonas, Serratia, Escherichia, and Klebsiella
(Think of the gentamicin Judo expert attacking the Red Shogun protecting his daughter, Mona.)
Which Gram-positive bacterium is often targeted with aminoglycosides?
Enterococcus endocarditis
Think of the drummer playing the purple Enterococcus drums.
Aminoglycosides are often inactivated by ______________.
acetylation
How might ototoxicity from aminoglycosides manifest?
Aminoglycosides can damage both the cochlea and the vestibular nucleus, so the ototoxicity from aminoglycosides can present as hearing loss or vertigo.
What will the nephrotoxicity from aminoglycosides appear as?
Brown casts in the urine (like the brown mud coming out of the tubule-shaped rain gutter next to the amikacin warrior)
What are two absolute contraindications of aminoglycoside use?
Pregnancy (which would result in deafness in the newborn) and myasthenia gravis (because of neuromuscular blockade)
(Think of the tarantula on the gong and the electrical socket on the GRAVe.)
