University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

372

Pages:

1
Author:

Prince Sampson

2.6 – “Feudal aassassins”: ssassins”: amin aminoglycosides oglycosides • Aminoglycosides inhibit ribosomes, halting translation (Kanji translators with tRNA hats). Bactericidal (dead translator). Irreversibly bind 30S ribosomal subunit, inhibiting formation of initiation complex, causing misreading mRNA (clock at 30 bound by sai-wielding assassin; smeared kanji; dead translator) • Used in treatment of aerobic G- bacilli (red bacilli bricks in wall). Aminoglycosides are actively transported across cell membrane via oxygen dependent process (bellows); to transport across cell wall, are usually coupled with cell wall active drugs to enhance ability to enter cell (e.g. β-lactams, vancomycin) (β-lactam bombs which look like the β-lactam planet). • Used especially when there is suspicion of sepsis or resistance. IV administration d/t poor oral absorption (ivy rope) • When coupled with wall agents, also effective against enterococcus. Useful in enterococcal endocarditis (diplococcus taiko drums). However, are intrinsically resistant to low to moderate levels of aminoglycosides, in part d/t acetylation enzyme that modifies aminoglycosides (drummer throwing stars at ninjas). • Resistance can develop with changes specific modifying enzymes, mutations to the ribosomal proteins, or mutations to the porins. • Neomycin (ninjutsu master) o Remains active in the GI tract when taken orally (colon-shaped pipe). o Useful in bowel prep before colorectal surgery (scalpel shuriken) • Paromomycin (pair of mice) o Remains active in the GI tract when taken orally (colon-shaped pipe). Useful in bowel prep before colorectal surgery o Luminal agent against parasites • Streptomycin (sai wielding wilderness specialist) o Effective in tularemia & plague Tx, spread by contact with ticks from rabbits (rabbit hoodie) and fleas from a variety of hosts (small woodland creature). • Gentamycin (judo master) o Used in treatment of nosocomial infections (red G- shogun). Include septicemia (red armor), complicated UTI (gold bladder pouch), intraabdominal infections (colonic armor plates), nosocomial RTI (lung patches), osteomyelitis (fish-bone shaped helmet) o Pseudomonas activity (Mona in the background) • Tobramycin (cobra ninja) o Similar spectrum to gentamycin. o Pseudomonas activity. • Amikacin (katana master) o Broadest spectrum, including resistant to enterococcal acetylation ( o Pseudomonas activity (Mona in the background) o Most expensive • Adverse effects o Ototoxicity – may result in vestibular or cochlear damage (gong looks like eardrum getting struck by sai). Often irreversible. o Nephrotoxicity (kidney shaped armor). More likely to be seen in renal insufficiency, and when co-administered with other nephrotoxic agents including loop diuretics ▪ d/t ATN (rusty downspout draining brown, muddy water, for muddy brown casts) ▪ May see ↑Crt & serum aminoglycoside levels. monitor drug concentration (peaks and troughs of mountainous terrain in the back) o Myasthenia gravis is absolute contraindication (rock that looks like an electrical outlet) o Deafness in neonate, so contraindicated in pregnancy (tarantula & pregnant woman)