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