What are the toxicities of aminoglycosides?
The toxicities of aminoglycosides include nephrotoxicity, ototoxicity (vestibular and auditory) and, rarely, neuromuscular blockade and hypersensitivity reactions. Nephrotoxicity receives the most attention, perhaps because of easier documentation of reduced renal function, but it is usually reversible.
What drugs are aminoglycosides?
The aminoglycoside class of antibiotics consists of many different agents. In the United States, gentamicin, tobramycin, amikacin, plazomicin, streptomycin, neomycin, and paromomycin are approved by the US Food and Drug Administration (FDA) and are available for clinical use.
Why is there no aminoglycosides in myasthenia gravis?
Aminoglycosides should be avoided in patients with myasthenia gravis because of the risk of prolonged neuromuscular blockade.
Why are anaerobes resistant to aminoglycosides?
Aminoglycosides are not active against anaerobes because their uptake across bacterial cell membranes depends on energy derived from aerobic metabolism. Consequently, they have markedly reduced activity in areas of low pH and oxygen tension (e.g., abscesses).
What is aminoglycoside used for?
Aminoglycosides are used in the treatment of severe infections of the abdomen and urinary tract, as well as bacteremia and endocarditis. They are also used for prophylaxis, especially against endocarditis. Resistance is rare but increasing in frequency.
What is another name for aminoglycoside?
Examples of aminoglycosides include: Gentamicin (generic version is IV only) Amikacin (IV only) Tobramycin.
Which drug is contraindicated in myasthenia gravis?
Medications reported to cause exacerbations of myasthenia gravis include the following: Antibiotics – Macrolides, fluoroquinolones, aminoglycosides, tetracycline, and chloroquine. Antidysrhythmic agents – Beta blockers, calcium channel blockers, quinidine, lidocaine, procainamide, and trimethaphan.
What antibiotics are contraindicated in myasthenia gravis?
These antibiotics have black box warnings and should not be used for individuals with myasthenia gravis:Fluoroquinolones (Ciprofloxacin (“Cipro”), levofloxacin, gatifloxacin, femifloxacin, norfloxacin, ofloxacin)Ketek (telithromycin)
What drugs should be avoided in myasthenia gravis?
Drugs to avoid Commonly-used medications like ciprofloxacin or certain other antibiotics, beta-blockers like propranolol, calcium channel blockers, Botox, muscle relaxants, lithium, magnesium, verapamil and more, can worsen the symptoms of myasthenia gravis.
Does gentamicin have anaerobic coverage?
Gentamicin, an aminoglycoside antibiotic, is bactericidal. Gentamicin passes through the gram-negative membrane in an oxygen-dependent active transport. As oxygen is required, this is why aminoglycosides are not effective in anaerobic bacteria.
Is vancomycin an aminoglycoside?
Another useful attribute of aminoglycosides is their synergism with antibiotics that inhibit bacterial cell wall biosynthesis, such as β-lactams and vancomycin. Finally, aminoglycosides have relatively predictable pharmacokinetic characteristics that allow them to be dosed to minimize their inherent toxicities.
Which antibiotic can be used against several anaerobic organisms?
The most effective antimicrobials against anaerobic organisms are metronidazole, the carbapenems (imipenem, meropenem and ertapenem), chloramphenicol, the combinations of a penicillin and a beta-lactamase inhibitor (ampicillin or ticarcillin plus clavulanate, amoxicillin plus sulbactam, and piperacillin plus tazobactam …
Mecanismo de Ação Dos aminoglicosídeos
Toxicidade Ou Precaução Dos aminoglicosídeos
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Ao se administrar os aminoglicósidos é preciso ter cuidado e atenção a sua toxicidade. Os principais efeitos adversos a essa classe de antibióticos são os seguintes: 1. Ototoxicidade– considerado o efeito principal e dependente da dose e duração do tratamento. O fator principal é que os fármacos se concentram no líquido labiríntico, de onde mudam destruindo as células se…
Interações farmacológicas
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Não se deve administrar aminoglicosídeos juntamente com outros fármacos ototóxicos como diuréticos de asa ou minociclina. É arriscado o emprego concorrente com outros fármacos nefrotóxicos, como anfotericina B, vancomicina, ciclosporina e cisplatino. Deve se ter cuidado o uso desses antibióticos com os relaxantes musculares.
Mecanismo de Acción
Clasificación
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Los aminoglucósidos se clasifican en dos grandes grupos según tengan un aminociclitol con o sin componente aminoglucósido: aminoglucósidos con aminociclitol y aminociclitol sin aminoglucósido. En el primer grupo, que son los que contienen aminociclitol con componente aminoglucósido, existen dos subgrupos. Estos subgrupos se forman por los diferentes compon…
Efectos Adversos
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Todos los aminoglucósidos son potencialmente tóxicos para el sistema renal, el aparato auditivo y el sistema vestibular. Estos efectos tóxicos pueden ser reversibles o irreversibles. Dichas consecuencias secundarias adversas dificultan la administración y el uso de estos antibióticos. Cuando se necesita suministrar un aminoglucósido por tiempos prolongados y a dosis altas es …
Resistencia A Los Aminoglucósidos
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La resistencia de los microorganismos a los aminoglucósidos puede deberse a alguna de las siguientes causas: 1) Las membranas de la bacteria son impermeables a estos antibióticos 2) los ribosomas de estas bacterias tienen una baja afinidad por el antibiótico 3) las bacterias sintetizan enzimas que inactivan al aminoglucósido. Las dos primeras causa…
Indicaciones
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Aunque se han desarrollado antibióticos menos tóxicos, el uso de los aminoglucósidos sigue siendo una herramienta importante para combatir infecciones severas causadas por enterococos o estreptococos. La gentamicina, la amikacina, la tobramicina y netilmicina tienen un espectro amplio contra bacterias aeróbicas Gram negativas. La kanamicina y la estreptomicina tienen un …
Contraindicaciones
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Los aminoglucósidos están contraindicados en pacientes con reacciones alérgicas a estos antibióticos. No deben usarse en los casos de enfermedades causadas por gérmenes que son resistentes. No deben usarse durante el embarazo si existen alternativas menos tóxicas. Existen contraindicaciones relativas en pacientes con enfermedades renales y/o problemas auditivos.
Referencias
- Boussekey, N., & Alfandari, S. (2007). Aminoglucósidos. EMC-Tratado de Medicina, 11(1), 1-4.
- Durante-Mangoni, E., Grammatikos, A., Utili, R., & Falagas, M. E. (2009). Do we still need the aminoglycosides? International journal of antimicrobial agents, 33(3), 201-205.
- Goodman and Gilman, A. (2001). The pharmacological basis of therapeutics. Tenth edition. McGraw-Hill
- Boussekey, N., & Alfandari, S. (2007). Aminoglucósidos. EMC-Tratado de Medicina, 11(1), 1-4.
- Durante-Mangoni, E., Grammatikos, A., Utili, R., & Falagas, M. E. (2009). Do we still need the aminoglycosides? International journal of antimicrobial agents, 33(3), 201-205.
- Goodman and Gilman, A. (2001). The pharmacological basis of therapeutics. Tenth edition. McGraw-Hill
- Kotra, L. P., Haddad, J., & Mobashery, S. (2000). Aminoglycosides: perspectives on mechanisms of action and resistance and strategies to counter resistance. Antimicrobial agents and chemotherapy, 4…
