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Introduction
  • Classification
    • antibiotic
      • anti-ribosomal 
        • anti-30S ribosomal subunit
          • aminoglycosides
  • Drugs
    • gentamicin
    • neomycin
    • amikacin
    • tobramycin
    • streptomycin
Mechanism
  • Action
    • bactericidal
    • binds to 30S ribosomal subunit 
      • inhibit formation of initiation complex 
      • Aminoglycosides inhibit initiAtion
      • cause misreading of mRNA
    • accumulates inside bacteria via O2-dependent uptake
      • cannot be used against anaerobes
      • "aminO2glycoside"
  • Resistance
    • via modification by acetylation, adenylation, or phosphorylation 
    • Aminglycoside resistance is by Acetylation
Uses
  • Severe infections with Gram-negative rods
    • aerobes only
    • synergistic with β-lactam antibiotics
  • Gentamicin
    • most widely used
    • nosocomial infections
  • Neomycin
    • toxic
    • topically for skin infections
    • bowel surgery
  • Amikacin
    • broadest spectrum
    • nosocomial infections
  • Tobramycin
    • Pseudomonas aeruginosa
  • Streptomycin
    • oldest aminoglycoside
    • resistance is common
Adverse effects
  • Nephrotoxicity
    • especially when used with cephalosporins
  • Ototoxicity 
    • especially when used with loop diuretics
  • Avoid in pregnancy
    • teratogen
    • ototoxicity
  • Neuromuscular block in very high doses
 

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