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Why is it important to monitor renal function during aminoglycoside treatment?
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Aminoglycosides are nephrotoxic, so monitoring renal function tests like BUN, creatinine, and GFR is crucial to prevent kidney damage.
What clinical indicators suggest that aminoglycosides are effectively treating an infection?
Reduction in fever, stable blood pressure and heart rate, and normal white blood cell count.
What conditions heighten the risk of ototoxicity when using aminoglycosides?
Concurrent use of other ototoxic drugs like Loop Diuretics and pre-existing ear disorders.
Name three gram-negative bacteria targeted by aminoglycosides.
E. coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
Describe the mechanism by which aminoglycosides kill bacteria.
Aminoglycosides inhibit protein synthesis by binding to the 30S ribosomal subunit, causing misreading of the genetic code and production of nonfunctional proteins.
What is the common use of aminoglycosides in combination therapy?
They are often combined with Penicillin to enhance the penetration of cell walls and increase antibacterial efficacy.
For what specific severe infections are aminoglycosides particularly prescribed?
Septicemia, severe urinary tract infections, endocarditis, and severe hospital-acquired pneumonia.
What symptoms indicate ototoxicity due to aminoglycosides?
Hearing loss, tinnitus, and dizziness, which can be irreversible.
What is the mnemonic 'GNATS' used for?
GNATS stands for Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin - all aminoglycosides.
Why are aminoglycosides not typically used alone for gram-positive infections?
Aminoglycosides have limited effectiveness against gram-positive bacteria and are often used in combination with other antibiotics for a synergistic effect.
What serious neuromuscular effect can aminoglycosides cause, and who is at increased risk?
Aminoglycosides can cause neuromuscular blockade, leading to muscle weakness and respiratory failure, especially in patients with neuromuscular disorders.
What type of bacteria are aminoglycosides most effective against?
Aminoglycosides are most effective against gram-negative bacteria.
List the routes of administration for aminoglycosides and provide an exception to the usual routes.
Aminoglycosides are usually given IM or IV. Tobramycin can be inhaled for cystic fibrosis lung infections.
How should peak and trough levels for aminoglycosides be monitored?
Peak levels should be checked 1 hour after IM or 30 minutes post IV infusion, and trough levels right before the next dose.
What are the primary toxicities associated with aminoglycosides?
Nephrotoxicity (kidney damage) and ototoxicity (ear damage).
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