This document discusses aminoglycoside antibiotics, including their uses, side effects, and drug interactions. Some key points:
1. Aminoglycosides inhibit protein synthesis and are bactericidal. They are used to treat infections like sepsis and in combination with beta-lactams.
2. Main side effects are nephrotoxicity and ototoxicity. Drug interactions can increase these risks, such as when combined with loop diuretics.
3. Aminoglycosides interact with various other drugs and should be used carefully with penicillins, NSAIDs, cephalosporins, magnesium salts, and digoxin due to risks like nephrotoxicity or respiratory arrest
2. *They are type of antibiotic which inhibition protein synthesis.
*it is bactericidal.
*Used to suspicion sepsis and other infection.
*Used in combination with B-lactum in therapy.
*Dosage form : injection (vial) ,tab ,cream ,oint, solution for skin apply.
*Teratogenicity for pregnant women.
Drugs in this class
4. * Vial(400mgml)
* Agonist endocarditis and
2nd line for T.B if
streptomycin shows
resistance, also in
tularemia.
5. * Vial(400mgml)
* Treated sepsis ,meningitis
and pneumonia
* topical (cream ,oint ,
solution 0.1-. 0.3%
* Used in burns , wounds,
skin lesion.
6. * Tab (500mg)syrup (125/ml)and
cream.
* Toxic if inj.
* Treated hepatic coma=decrease
NH4 intoxication
* In bowel surgery =decrease flora
* In intestinal amebiasis.
7. The main side effects are
1.Autotoxicity 2.Nephrotoxicity
8. 1.With penicillin
Aminoglycoside + penicillin =
Inactivation of AGS
How?
* This happen when penicillin destroy the rind of
Aminoglycoside.
Solution :
* Don’t mix in one syringe or in the same time just
separate 2 hours between two drugs.
9. 2.With loop diuretic
Aminoglycoside + loop diuretic =
oto-toxicity
How?
*Aminoglycosides or etacrynic acid alone can damage
the ear and cause deafness so together lead to
additive effect .but furosemide did not increase
either aminoglycoside-induced nephrotoxicity, or
ototoxicity
Solution :
* Avoid excessive dose and need monitor.
* Use other antibiotics.
10. 3.With NSAIDs
Aminoglycoside + NSAIDs(ibuprofen ,diclofen Na…,ect)=
Increase in premature infants.
How?
*Aminoglycosides are excreted by renal filtration,
which can be inhibited by indometacin or ibuprofen.
This may result in the retention of the
aminoglycoside.
Solution :
* Don’t combination If need to used decrease dose of
AGS before use NSAIDs
11. 4.With cephalosporin
Aminoglycoside + cephalosporin=
Nephrotoxicity .
How?
*The nephrotoxic effects of gentamicin and tobramycin are
well documented, and some (mostly older) cephalosporins
are known to be nephrotoxic, especially in high dose.
However, it appears that doses that are well tolerated
separately can be nephrotoxic when given together.
Solution :
*Monitor aminoglycoside concentrations and kidney function.
12. 5.With Mg salts
Aminoglycoside + Mg salts for woman with perclampsia=
Respiratory arrest in infant.
How?
*Magnesium ions and the aminoglycosides have
neuromuscular blocking activity, which can be additive
(Neuromuscular blockers + Magnesium compounds and
‘Neuromuscular blockers + Aminoglycosides Lead to block
the actions of the respiratory muscles.
Solution :
* Increase dose of digoxin .