Kipengele K,
Bpharm
Basic Pharmacology
NTA Level 4 Semester 2
2020
1
Kipengele K,
Bpharm
Description of Aminoglycoside Drugs
Session 6:
By the end of this session students are
expected to be able to:
• List indications of aminoglycosides
• List contraindications of aminoglycosides
• Describe dose, dosage and course of
aminoglycosides
• List side effects and adverse effects of
aminoglycosides
• Describe interactions and precautions of
aminoglycosides
The aminoglycosides include
• Systemic • Topical(Eye/Skin)
aminoglycosides aminoglycosides
– Streptomycin, – Neomycin
– Kanamycin, – Framycetin
– Amikacin, – Gentamicin
– Gentamicin,
– Tobramycin
Indications of Aminoglycosides
• All aminoglycosides are bactericidal and active
against some Gram-positive and many Gram-
negative organisms.
• Amikacin, gentamicin, and tobramycin are also
active against Pseudomonas aeruginosa.
• Streptomycin is active against Mycobacterium
tuberculosis and is now almost entirely
reserved for tuberculosis.
Contraindications of Aminoglycosides
The aminoglycosides are contraindicated in:
• Myasthenia gravis(weakness in the skeletal
muscles)
• In patients with renal failure
• Hearing impairment
• Pregnancy
Dose, Dosage and Course of Aminoglycoside
Gentamycin
• Multiple daily dose regimen, by intramuscular or by
slow intravenous injection over at least 3 minutes or
by intravenous infusion, 3–5 mg/kg daily (in divided
doses every 8 hours)
Neomycin
• Given by mouth,
– Pre-operative bowel sterilisation, 1 g every hour for
4 hours, then 1 g every 4 hours for 2–3 days,
– Hepatic coma, up to 4 g daily in divided doses
usually for 5–7 days
Dose, Dosage and Course of Aminoglycoside
......
Amikacin
• Given by intramuscular or by slow intravenous
injection or by infusion, 15 mg/kg daily in 2
divided doses, can be increased to 22.5 mg/kg
daily in 3 divided doses in severe infections;
• Max. 1.5 g daily for up to 10 days (max.
cumulative dose 15 g)
Side Effects and Adverse Effects of
Aminoglycosides
All aminoglycosides are ototoxic and nephrotoxic
• This is more likely to be encountered when therapy is
continued for more than 5 days, at higher doses, in the
elderly, and in the setting of renal insufficiency)
• Neomycin, kanamycin, and amikacin are the most
ototoxic agents
• Streptomycin and gentamicin are the most
vestibulotoxic
• Neomycin, tobramycin, and gentamicin are the most
nephrotoxic
Interactions and Precautions of
Aminoglycosides
Interactions:
• Concurrent use with: loop diuretics eg,
furosemide, ethacrynic acid
• Other nephrotoxic antimicrobial agents eg,
vancomycin or amphotericin) potentiates
nephrotoxicity .
Precautions
• The above drugs should be avoided if possible
when using aminoglycosides.
Key Points
• Commonly used Aminoglycosides are:
streptomycin, neomycin, kanamycin, amikacin,
gentamicin, tobramycin
• Aminoglycosides are active against gram-
negative enteric bacteria
• Aminoglycosides are contraindicated in
myasthenia gravis, renal and hearing problems
• Aminoglycosides are mainly given by injection
Self Evaluation
• What are the indications of aminoglycoside drugs?
• What are the contraindications of aminoglycoside
drugs?
• What are the common side effects of aminoglycoside
drugs?
