Aminoglycosides

Dr Iram Kamal
Learning outcomes

By the end of this 45 minutes lecture, the students should

be able to know:
 The names of commonly available aminoglycosides
 Pharmacokinetics, pharmacodynamics, resistance
mechanisms & toxicity of aminoglycosides
Sources

 Actinomycetes
 Streptomyces: suffix ; mycin e.g Tobramycin
 Micromonospora: suffix ; micin e.g Gentamicin
 Amino sugars attached by glycosidic linkages
 Water soluble
 Polar compounds
 Cant cross lipid membranes
 Parenteral
 Not metabolized
 Glomerular filtration
Key points

 MIC(minimum inhibitory concentration):

lowest concentration of an antibiotic capable of
inhibiting growth of an organism in a defined
growth medium
 Time dependent killing:
The efficacy is directly related to time above MIC
& becomes independent of concentration once
MIC is obtained.
 Concentration dependent killing:
As the plasma level is increased above the MIC,
Aminoglycosides kill an increasing proportion of
bacteria & do so at a more rapid rate
 Postantibiotic effect:
The killing action of an antibiotic continues even
when their plasma levels have declined below
measurable levels
 Single large doses are better then multiple small
doses
 AGs are more effective & less toxic at such dosing
regimens
Resistance mechanisms
Spectinomycin

 Aminoglycitol
 Related to Aminoglycosides
 Backup drug for treatment of Gonorrhea, if
allergy to Beta lactams
Side effects

 Ototoxicity ( more with loop diuretics)

Auditory toxicity
Vestibulo toxicity
 Nephrotoxicity (more with: cephalosporins, vancomycin,
Amphotericin B)
ATN
 Neuromuscular blockade
respiratory paralysis
 Allergic skin reactions
MCQs

Q1) Aminoglysides use in pregnancy can lead to

following defect in the new born:
A. Teeth anomelies
B. Bony defects
C. Hearing defect
D. Facial anomelies
MCQ

Aminoglycoside used in treatment of tuberculosis is:

A. Gentamicin
B. Neomycin
C. Tobramycin
D. Streptomycin
MCQ

Which of the following Aminoglycosides is used as an

ophthalmic solution for bacterial infections:
A. Tobramycin
B. Kanamycin
C. Amikacin
D. Spectinomycin
MCQ

Aminoglycosides act by:

A. DNA gyrase inhibition
B. Protein synthesis inhibition
C. Blocks production of RNA
D. Cell wall synthesis inhibition
MCQ

Aminoglycoside used before bowl surgery to

decrease aerobic flora is:
a) Neomycin
b) Amikacin
c) Netilmycin
d) Gentamicin
MCQ

Which of the following aminoglycosides:

A. Netilmicin
B. Paramomycin
C. Neomycin
D. Tobramycin
THANK YOU