1) Aminoglycosides are a class of bactericidal antibiotics that interfere with protein synthesis in bacteria. They are effective against many gram-negative aerobic bacteria.
2) Their mechanism of action involves binding to the 30S ribosomal subunit and inducing misreading of mRNA, which breaks up polysomes.
3) Common toxicities include ototoxicity, nephrotoxicity, and neuromuscular blockade. Gentamicin and amikacin are more nephrotoxic while certain drugs like streptomycin and tobramycin exhibit both vestibular and cochlear ototoxicity.
The aminoglycoside class of antibiotics consists of many different agents. In the United States, gentamicin, tobramycin, amikacin, plazomicin, streptomycin, neomycin, and paromomycin are approved by the US Food and Drug Administration (FDA) and are available for clinical use.
Macrolides are a class of drugs used to manage and treat various bacterial infections. Azithromycin, clarithromycin, and erythromycin are commonly used to treat infections like pneumonia, sinusitis, pharyngitis, and tonsillitis. They are also used in uncomplicated skin infections and otitis media in pediatric patients.
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Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
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http://sandymillin.wordpress.com/iateflwebinar2024
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This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
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Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
2. Aminoglycosides
• Streptomycin – 1944
• Actinomycetes – Streptomyces griseus
• Bactericidal antibiotics
• Interfere with protein synthesis
• Used to treat aerobic Gram –ve bacteria
• Resemble each other in MOA, pharmacokinetic
therapeutic and toxic properties
• Relatively low margin of safety
• Exhibit ototoxicity and nephrotoxicity
10. Mechanism of action
• Initially they penetrate
bacterial cell wall, to reach
periplasmic space through
porin channels (passive
diffusion)
• Further transport across
cytoplasmic membrane takes
place by active transport by
proton pump; an oxygen-
dependent process
11. Mechanism of Action
• Bind 30S ribosomal
subunits and interfere
the initiation complex
• Induce misreading of
genetic code on
mRNA
• Breakup of polysomes
into monosomes
12. Post antibiotic effect
• Aminoglycosides exhibit concentration
dependent killing.
• They also possess significant Post-antibiotic
effect.
• Single daily dosing at least as effective as and
no more toxic than multiple dosing.
13. Mechanism of resistance
• Synthesis of plasmid mediated bacterial
transferase enzyme: Inactivate aminoglycosides
• ↓ transport into bacterial cytosol
• Deletion/alteration of receptor protein on 30 S
ribosomal unit by mutation: prevents
attachment
14. Antibacterial spectrum
• Primarily against Gm –ve aerobic bacilli
– Proteus, pseudomonas
– E.Coli,enterobacter
– Klebsiella
– Shigella
• Only few Gm +ve cocci:
– staph aureus, strepto viridans
• Not effective against Gm +ve bacilli, Gm-ve
cocci and anaerobes
15. Pharmacokinetics
• Highly polar basic drugs: poor oral BA
• Administered parenterally or applied locally
• Poorly distributed and poorly protein bound
• Do not undergo any significant metabolism
• Nearly all IV dose is excreted unchanged in
urine
• Dose adjustment is needed in renal
insufficiency
17. Dose for a case of renal insufficiency
= Normal therapeutic dose
Sr creatinine value (mg/dl)
18. Dose for a case of renal insufficiency
• Cockroft gault formula:
CrCl = (140-age) x weight [kg]
(sCr x 72)
– For females multiply above value by 0.85
• Corrected dose = Normal dose x pt CrCl
Normal CrCl
19. Clinical uses
• Gram –ve bacillary infection
– Septicaemia, pelvic & abdominal sepsis
• Bacterial endocarditis –
– enterococcal, streptococcal or staphylococcal infection of
heart valves
• Pneumonias, Tuberculosis
• Tularemia
• Plague, Brucellosis
• Topical – Neomycin, Framycetin.
• Infections of conjunctiva or external ear
• Tosterilize the bowel of patients who receive
immunosuppressive therapy, before surgery & in
hepatic coma
21. Ototoxicity
• Impairment of VIII cranial nerve function
• May be irreversible
• Cochlear damage
– Hearing loss and tinnitus
– More with neomycin , amikacin and kanamycin
• Vestibular damage
– Vertigo, ataxia, loss of balance
– More with Streptomycin, gentamycin
• Tobramycin has both types of toxicity
• Netilimycin claimed to have low ototoxicity
22. Nephrotoxicity
• Gentamicin, amikacin and tobramycin are
more toxic than streptomycin
• Responsible for 10-15% of all renal failure
cases
• Reversible if drug promptly discontinued
• ↓ GFR, ↑ sr creatinine
• ↓clearance of antibiotic → ↑ ototoxicity
23. Neuromuscular blockade
• Cause N-M junction blockade by
– Displacing Ca2+ from NM junction
– By blocking post synaptic NM receptors
– Inhibiting Ach release from motor nerve
• Neomycin & streptomycin: more propensity
• Tobramycin least likely to produce it
• Myasthenic weakness ↑by these drugs
24. Precautions / Contraindications
• Pregnancy: foetal ototoxicity
• With other ototoxic drugs: furosemide, minocycline
• With nephrotoxic drugs: vancomycin ,cisplatin
• Elderly patients
• Those with kidney disease
• Cautious use of muscle relaxants
• Do not mix with any other drug in same
syringe
25. Streptomycin
• Ribosomal resistance develops fast
• Limited usefulness as single agent
• Plague, tularemia and brucellosis
– In combination with tetracycline
• Reserve first line drug for tuberculosis used
only in combination
26. Gentamicin
• Obtained from Micromonospora purpurea
• Most commonly used aminoglycoside
– More potent than Streptomycin
– Broader spectrum: pseudomonas, proteus, E.coli,
klebsiella, enterobacter, serratia
– Low cost, reliability of use, long experience
– Acts synergistically with ampicillin, penicillin G,
Ticarcillin, ceftriaxone, Vancomycin
• Ineffective against M.tuberculosis
• Relatively more nephrotoxic
27. Gentamicin (Uses)
• Use restricted to serious Gm-ve bacillary infections
• Septicaemia, sepsis, fever in immunocompromised
patients
– Used with penicillins
• Pelvic infections : with metronidazole
• Coliform infection: with ampicillin or ceftriaxone
• Pseudomonal infections: with ticarcillin
• Meningitis by Gm-ve bacilli : III generation
cephalosporin alone or with gentamicin
29. Tobramycin
• Identical to gentamicin
• Used in pseudomonas and proteus infections
• Ototoxicty and nephrotoxicity probably lower
Sisomicin
-hemolytic
• Identical to gentamicin
• More potent on pseudomonas and
streptococci
• Used interchangeably with gentamicin
30. Amikacin
• Less toxic semisynthetic derivative of kanamycin
• Resistant to enzymes that inactivate gentamicin
and tobramcyin
• Widest spectrum of activity
• Uses:
– Same as gentamicin
– Reserve drug for hospital acquired Gm-ve bacillary
infections
– Multidrug resistant TB along with other drugs
• Dose : 15mg/kg/day in 1-3 doses
31. Netilimicin
• Semisynthetic derivative of sisomicin
• Relatively resistant to aminoglycoside
inactivating enzymes
• More active against klebsiella, enterobacter &
staphylococci
• Less active against pseudomonas aeruginosa
• Doses and pharmacokinetics similar to
gentamicin
32. Neomycin
• wide spectrum active against Gm-ve bacilli
and some gm+ve cocci
• Pseudomonas and strep.pyogenes not
sensitive
• Too toxic for parenteral use , limited to topical
use
33. Neomycin (uses)
• Topically used in skin, eye and external ear infections
combined with bacitracin or polymyxin-B to widen
antibacterial spectrum and to prevent emergence of
resistant strains
• Orally
– Preparation of bowel before surgery 1 gm TDS
– Hepatic coma: Supresses ammonia forming
coliforms prevents encephalopathy (Lactulose
more preferred)
• Bladder irrigation along with polymyxin B
34. Framycetin
• Very similar to neomycin
• Too toxic for systemic administration
• Used topically on skin, eye ear