aminoglycosides

Question 1

 Some drugs and aminoglycosides
• As the plasma level is increased above the MIC, the drug kills an increasing proportion of bacteria at a more rapid rate

Answer 1

conc dependent

Question 2

 Any antibiotic, including penicillins and cephalosporins
• Directly related to time above MIC
• Independent of concentration once the MIC is reached

Answer 2

TIME DEPENDENT

Question 3

 Structurally related amino sugars attached by glycosidic linkages


Answer 3

aminoglycosides

Question 4

are aminoglycosides polar or not

Answer 4

polar

Question 5

RoA of aminoglycosides

Answer 5

 Given intramuscularly or intravenously for systemic effects

Question 6

Are aminoglycosides absorbed orally?

Answer 6

no

Question 7

tissue penetration of aminoglycosides (full partial limited)

Answer 7

Limited

Question 8

 Does it readily cross the blood-brain barrier

Answer 8

no

Question 9

 Major mode of excretion

•

Answer 9

Glomerular filtration

Question 10

 Excretion is directly proportional to —- clearance

Answer 10

creatinine

Question 11

With normal renal function, elimination half-life is

Answer 11

2-3 h

Question 12

 Peak serum levels

 Measured at

Answer 12

30-60 minutes after administration

Question 13

 Trough serum levels

 Measured when

Answer 13

just before the next dose

Question 14

MoA of AG

Answer 14

 Bactericidal (irreversible) inhibitors of protein synthesis

Question 15

 Penetration of bacterial cell wall is partly dependent on ___________

Answer 15

O2-dependent active transport

Question 16

 Transport is enhanced by ________

Answer 16

cell wall synthesis inhibitors

Question 17

 Bind to _____ AND Interfere with protein synthesis

Answer 17

30S ribosomal unit

Question 18

ag interfere with protein synthesis by

Answer 18

1. Block formation of initiation complex
   
   2. Cause misreading of the code on the mRNA template
   3. Inhibit translocation

Question 19

MECHANISMS OF RESISTANCE

Answer 19

 Failure to penetrate into the cell

 Plasmid-mediated formation of inactivating enzymes

Question 20

• Primary mechanism of resistance

Answer 20

Plasmid-mediated formation of inactivating enzymes

Question 21

•
 Catalyze the acetylation of amine functions
 Transfer of phosphoryl or adenyl groups to the O2 atoms of hydroxyl groups on the aminoglycoside

Answer 21

Group transferases

Question 22

transferases produced by enzyme can inactivate

Answer 22

• Amikacin
• Gentamicin
• Tobramycin
• Not streptomycin
• Netilmicin is less susceptible and is active against more strains of organisms

Question 23

for Serious infections caused by aerobic gram (-) bacteria 
•	E. coli 			Enterobacter
•	Klebsiella		Proteus
•	Providencia		Pseudomonas
•	Serratia

Answer 23

GENTAMICIN, TOBRAMYCIN, and AMIKACIN

Question 24

 Tuberculosis
 Plague
 Tularemia
 Multi-drug-resistant (MDR) strains of M. tb resistant to streptomycin maybe susceptible to amikacin

Answer 24

STREPTOMYCIN

Question 25

 Used topically  Locally • In the GIT • Eliminate bacterial flora

Answer 25

NEOMYCIN

Question 26

 Reserved for serious infections resistant to other aminoglycosides

Answer 26

NETILMICIN

Question 27

 Aminocylitol related to aminoglycosides  Back-up drug  Intramuscular as single dose for gonorrhea

Answer 27

SPECTINOMYCIN

Question 28

A. OTOTOXICITY |  Auditory or vestibular damage (or both) maybe irreversible or reversible?

Answer 28

IRREVERSIBLE

Question 29

DRUGS RESPONSIBLE FOR | • Auditory impairment

Answer 29

Amikacin and kanamycin

Question 30

DRUGS RESPONSIBLE FOR | Vestibular dysfunction

Answer 30

Gentamicin and tobramycin

Question 31

OTOTOXICITY Risk is proportionate to the | • High if dosage is not modified in renal dysfunction

Answer 31

plasma levels

Question 32

 Increased with the use of loop diuretics |  Contraindicated in pregnancy

Answer 32

OTOTOXICITY Risk

Question 33

RESPONSIBLE FOR | • Allergic skin reactions like contact dermatitis

Answer 33

Neomycin

Question 34

C.  Rare  Curare-like block may occur at high doses

Answer 34

NEUROMUSCULAR BLOCKADE

Question 35

is neuromuscular blockade reversible or irre

Answer 35

reversible

Question 36

neuromuscular blockade causes

Answer 36

respiratory paralysis

Question 37

treatment of neuromuscular blockade

Answer 37

Calcium | Neostigmine

Question 38

treatment of neuromuscular blockade requires

Answer 38

Ventilatory support

Question 39

nephrotoxicity more common in (2)

Answer 39

```  Patients concurrently receiving • Amphotericin B • Cephalosporins • Vancomycin Elderly ```

Question 40

is nephrotoxicity reversible or irre

Answer 40

rever

Question 41

 Most nephrotoxic drugs

Answer 41

Gentamicin and tobramycin

Question 42

nephrotoxicity is in the form of

Answer 42

acute tubular necrosis