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Aminoglycosides

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What are the two main side effects with the aminoglycosides ?
Ototoxicity and nephrotoxicity
Name the aminoglcyosides
Gentamicin, Tobramicin, Amikacin, Neomycin and streptomycin
Which one is the MOST toxic ?
neomycin
Which one is the LEAST toxic ?
streptomycin
How do they work ?
they disrupt protein synthesis and cause cell death
What are two unique factors about the aminoglycosides as they relate to the action of the drug ?
They are concentration dependent AND also have a post antibiotic effect
How does concentration dependent and PAI affect prescribing ?
Studies have shown these characteristics make once daily dosing just as (if not more) effective AND least toxic to the patient
The major side effects of ototoxicity and nephrotocicity are related to peak or trough levels ?
They are related to excessive trough levels
Aminoglycosides are effective against...
aerobic gram negative bacilli such as enterobacter; psuedemonas, klebsiella, serratia and E.coli
Aminoglycosides are primarily used for what type of infection ?
nosocomial infections
What kind of adjustments would make for a renal patient when prescribing an aminoglycoside ?
Either reduce the dose or increase the dosing interval
What three factors increase the risk of ototoxicity ?
renal impairment; use with ethacrynic acid; using > 10 days
High peak levels will increase nephrotoxicity. True or False ?
False..nephrotoxicity is related to excessive total cumulative doses and excessive trough levels
Which two aminoglycosides are used in topical admin ?
Bacitracin and neomycin
What is another rare side effect of the aminoglycosides ?
neuromuscular blockade

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