AMINOGLYCOSIDE DRUGS GET DEEP UNDERSTANDING

Aminoglycoside Drugs:

Description of Aminoglycoside Drugs

The aminoglycosides include:

streptomycin, neomycin, kanamycin, amikacin, gentamicin, tobramycin

All aminoglycosides are bactericidal and active against some Gram-positive and many Gram-negative organisms .

Amikacin, gentamicin, and tobramycin are also active against Pseudomonas aeruginosa.

Streptomycin is active against Mycobacterium tuberculosis and is now almost entirely reserved for tuberculosis.

STEP 3: Contraindications of Aminoglycosides:

The aminoglycosides are contraindicated in:

Myasthenia gravis.

In patients with renal failure .

Hearing impairment Pregnancy .

STEP 4: Dose, Dosage and Course of Aminoglycoside.

The following are the commonly dose, dosage and courses of common aminoglycosides.

Gentamycin Multiple daily dose regimen, by intramuscular or by slow intravenous injection over at least 3 minutes or by intravenous infusion, 35 mg/kg daily (in divided doses every 8 hours).

Neomycin Given by mouth, pre-operative bowel sterilisation, 1 g every hour for 4 hours, then 1 g every 4 hours for 23 days, for Hepatic coma, up to 4 g daily in divided doses usually for 57 days.

Amikacin Given by intramuscular or by slow intravenous injection or by infusion, 15 mg/kg daily in 2 divided doses, can be increased to 22.5 mg/kg daily in 3 divided doses in severe infections; max. 1.5 g daily for up to 10 days (max. cumulative dose 15 g)

STEP 4: Side Effects and Adverse effects of aminoglycoside:

All aminoglycosides are ototoxic and nephrotoxic .This is more likely to be encountered when therapy is continued for more than 5 days, at higher doses, in the elderly, and in the setting of renal insufficiency.

Neomycin, kanamycin, and amikacin are the most ototoxic agents.

Streptomycin and gentamicin are the most vestibulotoxic.

Neomycin, tobramycin, and gentamicin are the most nephrotoxic .

STEP 5: Interactions and Precautions of Aminoglycosides:

Interaction and precaution of the aminoglycosides.

Concurrent use with: loop diuretics eg, furosemide, ethacrynic acid Other nephrotoxic antimicrobial agents eg, vancomycin or amphotericin) potentiates nephrotoxicity .

The above drugs should be avoided if possible when using aminoglycosides.