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Should the aminoglycosides (AMGS) be used for everyday infections, or be reserved for more serious infections? Why?
more serious infections - AMGS are usually given parenterally, and they are neprotoxic and ototoxic
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Are AMGS cidal or static? How do they work?
cidal. bind to nucleic acids in bacterial ribosomes, prevent protein synthesis
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Are AMGS most commonly given PO?
no. usually parenteral administration
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Do AMGS work well on anaerobic bacteria?
no
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How are AMGS excreted?
kidneys - glomerular filtration
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What parts of the body are AMGS toxic to?
kidneys and inner ear
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What are the clinical signs of ototoxicity?
hearing and vestibular problems - deaf, head tilt, circling, etc.
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How do you prevent nephrotoxicity when using aminoglycosides?
blood concentration of the drug must fall below a certain level between doses to give the kidneys a break. if the patient is renally impared, extend the dosage interval. monitor protein and casts in urine sediment. monitor BUN, creatinine, USPG. may give IV fluids.
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Why is it important to clean off a draining skin lesion before applying a topical preparation including an aminoglycoside?
puss and cellular debreis inactivate AMGS. extra nucleic acids available for AMGS to bind to.
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Which AMGS is usually given orally to work agaisnt bacteria in the gastrointestinal tract? Should it be given if the patient's GI tract is damaged?
neomycin. no - neomycin could get into the systemic circulation - it is very nephrotoxic
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Which AMGS is often mixed with bacitracin and polymixin B in topical preparations?
neomycin
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List 5 specific aminoglycosides.
- gentamycin
- neomycin
- strptomycin
- kanamycin
- amikacin
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What is a common ending to the nonproprietary name of most quinolones?
floxacin
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Are quinolones (fluoroquinolones) static or cidal?
cidal
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Are quinolones given orally or parenterally or both?
both
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Are quinolones indicated for prostatic infections?
yes
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How are quinolones excreted?
liver and kidneys
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What kind of problem can high doses of Baytril cause in cats?
blindness due to retinal changes
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What kind of problem can quinolones cause in growing dogs and horses?
defects in joint cartilage
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Why is it important to keep patients on quinolones well hydrated?
prevent crystal formation in kidneys
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List 5 specific quinolones
- enrofloxacin - Baytril
- ciprofloxacin - Cipron
- orbifloxacin - Orbax
- marbofloxacin - Zeniquin
- difloxacin - Dicural
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Name 2 older tetracyclines. Are they more hydrophilic or more lipophilic?
- tetracycline
- oxytetracycline
- more hydrophilic
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Name 2 newer tetracycline. Are they more hydrophilic or more lipophilic?
- doxycycline
- minocycline
- more lipophilic
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Are tetracyclines static or cidal?
static. do not give tetracyclines with penicillins or cephalosporins, which require actively growing and dividing bacteria to work on
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Are tetracyclines broad spectrum or narrow spectrum?
broad spectrum
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What foods should you avoid giving with the older tetracyclines? Why?
dairy products, antacids, kaopectate - older tetracyclines bind to divalent ions - Ca, Mg, Fe, Cu
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How are tetracyclines excreted?
mainly through the kidneys. enterohepatic circulation prevents major liver excretion
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Is enterohepatic circulation important in preventing major amounts of tetracyclines to actually leave the body by the liver?
yes
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Why do you avoid giving tetracyclines, especially older tetracyclines to pregnant and young animals.
causes enamel of teeth to be yellow, retards fetal bone growth
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Should you reduce the dose of tetracyclines given to patients in renal or liver failure?
yes
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What happens chemically to expired tetracycline and oxytetracycline?
they can decompose to a nephrotoxic compound
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What are common side effects from tetracycline in dogs? In cats?
- dogs: GI signs - vomiting, diarrhea, anorexia
- cats: fever, depression, abdominal pain
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Which tetracycline is newer, in more commone use, broader spectrum, less likely to cause teeth yellowing, is more lipid soluble, and is excreted mostly through the intestines?
doxycycline
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Which is safest to use in renal impaired patient - tetracycline or doxycycline?
doxycyccline
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Can doxycycline get into the CNS, prostate, and eye?
yes
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