Aminoglycoside

(Therapeutic use with interaction)

Dr.Safia A. Alrezami

Aminoglycoside

*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

Kanamycin

*Vial(50,250mg\ml).

*Treated the infection

of endocarditis and

2nd line for T.B if

streptomycin shows

resistance.

Streptomycin

* Vial(400mg\ml)

* Agonist endocarditis and 2nd line for T.B if streptomycin shows resistance, also in tularemia.

Gentamycin

* Vial(400mg\ml)

* Treated sepsis ,meningitis and pneumonia

* topical (cream ,oint , solution 0.1-. 0.3%

* Used in burns , wounds, skin lesion.

Neomycin

* Tab (500mg)syrup (125/ml)and cream.

* Toxic if inj.

* Treated hepatic coma=decrease NH4 intoxication

* In bowel surgery =decrease flora

* In intestinal amebiasis.

Side effect of AGS

The main side effects are

1.Autotoxicity

2.Nephrotoxicity

Drug interaction

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.

Drug interaction

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.

Drug interaction

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

Drug interaction

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.

Drug interaction

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 .

Drug interaction

6.With digoxin

Aminoglycoside + digoxin=

decrease conc. Of digoxin.

Solution :

* Increase dose of digoxin .

For more informationread also: *MED facts POCKET GUIDE OF DRUG

INTERACTIONS.

*Martindale36.

*katzung BASIC & CLINICAL

PHARMACOLOGY (2007).

*Stockley’s Drug Interactions.

THANK YOU FOR LISTENING