Aminiglycosides(Tobramycin,Amikacin)
Mechanism of action:
Aminoglycosides work by inhibiting protein synthesis in bacterial cells. They bind to the 30S ribosomal subunit and interfere with the decoding of mRNA, causing the production of nonfunctional or toxic proteins. This leads to the death of the bacterial cell.
Pharmacokinetics:
Aminoglycosides are absorbed poorly from the gastrointestinal tract and must be administered intravenously or by injection. They are rapidly distributed to the extracellular fluid, including the urine and bronchial secretions. Aminoglycosides are excreted primarily by the kidneys, and their clearance is reduced in patients with impaired renal function.
Dosing:
Aminoglycosides are usually dosed based on the patient's body weight and the severity of the infection. They are typically administered every 8 to 12 hours, and the dosage may need to be adjusted based on the patient's renal function.
Adverse effects:
Aminoglycosides can cause a number of adverse effects, including:
- Nephrotoxicity: Aminoglycosides can damage the kidneys and lead to kidney failure, especially in patients with pre-existing renal impairment.
- Ototoxicity: Aminoglycosides can damage the auditory and vestibular systems, causing hearing loss and balance problems.
- Neuromuscular blockade: Aminoglycosides can interfere with neuromuscular transmission, causing muscle weakness and respiratory paralysis.
- Allergic reactions: Aminoglycosides can cause allergic reactions, including rash, itching, and anaphylaxis.
Monitoring:
Aminoglycosides should be monitored closely for signs of toxicity, particularly in patients with impaired renal function. Blood levels of the drug should be monitored to ensure that therapeutic levels are maintained. In addition, patients receiving aminoglycosides should have regular hearing and kidney function tests.
Conclusion:
Aminoglycosides are a valuable class of antibiotics that are effective against a wide range of bacterial infections. However, they can cause serious adverse effects and should be used with caution in patients with impaired renal function. It is important to closely monitor patients receiving aminoglycosides and to adjust the dosage as needed to avoid toxicity.
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