10 points regarding Aminoglycosides: 1. Acts by a concentration dependent killing. 2. Capable of exerting a postantibiotic effect such that their killing action continues when their plasma levels have declined below measurable levels. 3. Polar compounds, not absorbed orally, so must be given in IV or IM. 4. Do not cross blood brain barrier. 5. Excretion is directly proportional to creatinine clearance, so dose should be adjusted in renal impairment. 6. Antimicrobial synergism with cell wall synthesis inhibitor. 7. Drug penetration through the bacterial cell wall is partly dependent on Oxygen dependent active transport, so show minimal activity against strict anaerobes. 8. Primary mechanism of resistance involves plasmid mediated formation of inactivating enzymes. 9. Auditory impairment is more likely with amikacin and kanamycin; vestibular dysfunction is more likely with gentamicin and tobramycin. Ototoxicity may be increased by the use of loop. diuretics. 10. Gentamicin and tobramycin are the most nephrotoxic.
Posted on: Fri, 15 Aug 2014 05:22:45 +0000