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Aminoglycosides Quiz
clinical kinetics
| Question | Answer |
|---|---|
| Are aminoglycosides bactericidal true or false | true: kills the bacteria |
| treatment indication gram negative infections | several dosing methods and no longer first line for most infections |
| treatment indication gram positive infections | creates a synergistic effect and used in combination with beta lactams or vancomycin |
| does aminoglycosides have post antibiotic effect | yes persistent antimicrobial activity even after the drug has cleared |
| Aminoglycosides Absorption | 100% systemic absorption with IV |
| Aminoglycosides Metabolism | Does not undergo hepatic metabolism |
| Aminoglycosides Distribution | Not protein bound small volume of distributions |
| Aminoglycosides elimination | Really cleared, unchanged. Half life of 2 hours. dependent on clearance. Half life increases when CrCl decreases |
| PK-PD | Efficacy is based on peak to MIC ratio. peak concentration are 10 times the MIC, Ratio being 10:1 |
| does exhibit concentration dependent activity true or false | True |
| when concentration increase, the extent/rate of bacterial killing increase true or false | True |
| Properties of aminoglycoside | small volume of distribution, are hydrophilic molecules, Poor CSF concentration, High concentration in urine |
| where in the body do amino glycosides go ? | Only distributes to places of water in the body |
| which populations will water content of your body change | babies and children, ICU patient, Burn patient, pregnancy, cystic fibrosis, volume overload |
| how does water content affect aminoglycosides concentration | Higher a patients Vd, the lower the concentration (peak) of aminoglycosides, the lower the effect of the drug. Dose of aminoglycosides increase as Vd increases. |
| Dosing of aminoglycosidess are influenced by | specific aminoglycoside used, infection site and organism, renal function , weight, body composition |
| extended interval method | Optimizes peak: MIC ratio, less risk of nephrotoxicity, optimizes the post antibiotic effect and concentration dependent killing effect, requires a random level, nomogram based dosing |
| Conventional/ traditional method | reduced fixed doses administered more frequently, protocols based dosing, body weight determine, CrCl determines dose interval, requires peak trough levels at steady state |
| Pharmacokinetic dosing method | used to design an extended interval and conventional regimen, PK parameters are customizable (individualized approach ) |
| aminoglycosides peak measures | efficacy |
| aminoglycosides trough measure | toxicity |
| aminoglycosides longer than 14 days concerns are | ototoxicity |
| trough greater than 1mg/L is associated with | nephrotoxicity |
| extended interval dosing Peak Gentamicin | 20 to 30mg/L |
| extended interval dosing Peak Tobramycin | 20 to 30mg/L |
| extended interval dosing Peak Amikacin | 40 to 60mg/L |
| extended interval dosing trough Gentamicin | < 1mg/L |
| extended interval dosing trough tobramycin | < 1mg/L |
| extended interval dosing trough Amikacin | < 4mg/L |
| conventional dosing peak Gentamicin | severe infection: 10mg/L |
| conventional dosing peak tobramycin | severe infection: 10mg/L |
| conventional dosing peak Amikacin | severe infection: 30mg/L |
| conventional dosing trough Gentamicin | < 1mg/L |
| conventional dosing trough Tobramycin | < 1mg/L |
| conventional dosing trough Amikacin | < 4mg/L |
| Synergy dosing Peak Gentamicin | 3 to 4mg/L |
| Synergy dosing trough Gentamicin | <1mg/L |
| Synergy dosing Peak Tobramycin | Not used |
| Synergy dosing Peak Amikacin | Not used |
| synergy dosing trough Amikacin | Not used |
| synergy dosing troughTobramycin | Not used |
Created by:
arcervantes