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NURS 3550: Gentamycin questions with correct answers
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NURS 3550: Gentamycin questions with correctanswers
Chapter 87 presents the aminoglycosides, antibiotics that inhibit protein
synthesis. The chapter begins with the basic pharmacology of these
agents. Correct Answer-
Aminoglycosides are narrow-spectrum antibiotics used primarily against
Correct Answer-aerobic gram-negative bacilli.
Aminoglycosides disrupt Correct Answer-protein synthesis, causing
rapid bacterial death.
The aminoglycosides can cause serious injury to the Correct Answer-
inner ear and kidneys. Because of these toxicities, indications for these
drugs are limited.
Aminoglycosides are highly Correct Answer-polar polycations. As a
result, they are not absorbed from the gastrointestinal tract and therefore
must be administered parenterally to treat systemic infections.
The aminoglycosides are bactericidal. Cell kill is concentration
dependent. Therefore, the higher the concentration, the more rapidly an
infection clears. Correct Answer-
,Bactericidal activity persists for several hours after serum levels have
Correct Answer-dropped below the minimal bactericidal concentration;
this phenomenon is known as the postantibiotic effect.
The principal cause of bacterial resistance is the production of Correct
Answer-enzymes that can inactivate aminoglycosides. Of all the
aminoglycosides, amikacin is least susceptible to inactivation by
bacterial enzymes.
The principal use for parenteral aminoglycosides is treatment of Correct
Answer-serious infections caused by aerobic gram-negative bacilli.
One aminoglycoside—gentamicin—is now commonly used in Correct
Answer-combination with either vancomycin or a beta-lactam antibiotic
to treat serious infections with certain gram-positive cocci.
The aminoglycosides are eliminated primarily by Correct Answer-the
kidneys. Accordingly, to prevent serious toxicity, the dosage size must
be reduced or the dosing interval must be increased in patients with
kidney disease.
The aminoglycosides can produce Correct Answer-serious toxicity,
especially to the inner ear and kidneys. These structures are vulnerable
because aminoglycosides become concentrated within their cells.
, The risk of ototoxicity is related primarily to Correct Answer-
persistently elevated trough drug levels rather than to excessive peak
levels.
Patients should be monitored for Correct Answer-ototoxicity. The first
sign of impending cochlear damage is high-pitched tinnitus (ringing in
the ears). Ototoxicity is largely irreversible. Accordingly, if permanent
injury is to be avoided, aminoglycosides should be withdrawn at the first
sign of damage (i.e., tinnitus, persistent headache, or both).
Aminoglycosides can injure cells of the Correct Answer-proximal renal
tubules.
Nephrotoxicity correlates with Correct Answer-(1) the total cumulative
dose of aminoglycosides and (2) high trough levels.
Aminoglycoside-induced nephrotoxicity usually manifests as Correct
Answer-acute tubular necrosis.
Injury to the kidneys usually reverses after Correct Answer-
aminoglycoside use is discontinued.
Aminoglycosides can inhibit neuromuscular transmission, causing
Correct Answer-flaccid paralysis and potentially fatal respiratory
depression. Most episodes of neuromuscular blockade have occurred
following intraperitoneal or intrapleural instillation of aminoglycosides.
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