Pharmacology - Aminoglycosides 3

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Pharmacology - Aminoglycosides 3
2014-01-26 23:15:54
Pharmacology Aminoglycosides

Pharmacology - Aminoglycosides 3
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  1. Because Amikacin is derived from kanamycin, does it have strong toxicities associated with it?
    Less so, not like Kanamycin
  2. Can Amikacin be used to treat G+ organisms?
    Yes, but only some and only in combo with a cell wall inhibitor
  3. Mainly what type of bacteria are in Amikacin’s spectrum?
    Gram negative
  4. Why are we not likely to see treatments using Netilmicin?
    Not available in the US
  5. What other antibiotic is Netilmicin similar to and why?
    Amikacin, because it is also very resistant to enzymatic breakdown
  6. Is neomycin used systemically?
  7. Is neomycin fairly safe?
    No, very toxic
  8. How is neomycin usually used?
  9. Is neomycin broad or narrow spectrum?
  10. When would you use neomycin orally?
    In preparation for bowel surgery, to reduce the flora
  11. Can Neomycin be absorbed orally?
    Only if the GIT is not fully intact, like with ulcers
  12. What disease is contraindicated with oral neomycin?
  13. What use of Neomycin has conferred a lot of resistance?
    Oral treatment of GIT Enterococci
  14. In way ways can you help to reduce aminoglycoside toxicity?
    Once daily dosing, monitoring of levels after the first dose and before the next
  15. What should you test for when giving aminoglycosides?
    Renal function/Creatinine and drug levels, cellular enzymes in the urine
  16. The peak aminoglycoside measurement, taken 30 minutes after the first infusion in finishned, should be in what relative range?
    4-8 mg/L
  17. Is renal damage due to aminoglycosides usually reversible?
  18. What other drugs should be cautiously administered with aminoglycoside?
    Renally toxic drugs like Vanco, Cisplatin and Ampoteracin B
  19. What is the outcome of toxicity to the 8th cranial nerve?
    Ototoxicity, effecting balance and hearing
  20. Why do aminoglycosides cause ototoxicity?
    Because they concentrate in the otic fluids due to their positive charge
  21. When should you suggest hearing tests for patients on aminoglycosides?
    Chronic use
  22. What two aminoglycosides cause more hearing loss than the others?
    Kanamycin and amikacin
  23. If neomycin were used systemically, would hearing loss be reversible?
  24. Why are aminoglycosides cautioned with anesthesia?
    Cause Curare-like neuromuscular blockade and pre-junctional effect which prolongs the anesthetic effect
  25. How do aminoglycosides cause neuromuscular blockade?
    Block Ca channels in neuromuscular terminals and decrease release of Ach, causing muscle relaxation
  26. How can aminoglycoside neuromuscular blockade be reversed?
    Add Ca or Neostigmine, which prevents anti-cholinesterases form breaking down Ach
  27. Can aminoglycosides predispose you to toenail fungus?
  28. Can aminoglycosides put you at risk for optic neurosis (vision reduction)?
  29. Can aminoglycosides put you at risk for contraceptive failure?
  30. Can aminoglycosides cause peripheral neuritis (tingling in the peripheries)?
  31. Are allergies a major concern with aminoglycosides?
    Not really, but can happen
  32. Can toxicities form aminoglycosides last a long time?
    Yes, even years or permanent
  33. What is paramomycin used for?
    Treatment of parasitic infections: amebiasis and cryptosporidium