What are the side effects of aminoglycosides commonly used to treat pulmonary exacerbations?
We review the current literature on the side effects of aminoglycosides commonly used to treat pulmonary exacerbations of CF. The major side effects of aminoglycosides are kidney injury, hearing impairment and vestibular toxicity.
Are aminoglycosides toxic to humans?
But while aminoglycosides are working to kill the bad bacteria, they can also cause some serious toxic effects that can hurt the patient. To learn about side effects and potential toxicity of aminoglycosides, let's visit Jack, a patient in the hospital who is being treated with an aminoglycoside antibiotic.
What is an aminoglycoside?
An aminoglycoside is an antibiotic used to treat bacterial infections. Explore the different examples of aminoglycosides, their risks, including toxicity and side effects, and how to prevent negative reactions. Updated: 10/15/2021
What are aminoglycoside antibiotics used to treat?
Aminoglycoside antibiotics are a central component of the treatment of pulmonary exacerbations of cystic fibrosis (CF) and slow the decline in lung function which ultimately causes the death of most patients. The prognosis of CF has improved, and thus side effects of treatments have become increasingly important.
What are the main side effects of aminoglycosides?
What Are Side Effects of Aminoglycosides?Nephrotoxicity (deterioration of kidney function due to poisonous effect of the drug)Ototoxicity: may cause hearing loss.Neurotoxicity: may cause paralysis.Allergic reactions.Anemia (low hemoglobin in blood)Thrombocytopenia (low platelet count)
Is hepatotoxicity a side effect of aminoglycosides?
Liver injury from the aminoglycosides is rare, perhaps because the other side effects of aminoglycosides limit the amount that can be given. Isolated case reports of idiosyncratic hepatotoxicity have been published for most, but not all of the aminoglycosides. These resports have not always been very convincing.
What are the signs and symptoms of aminoglycoside toxicity?
GENERAL FEATURES OF AMINOGLYCOSIDE NEPHROTOXICITY Nephrotoxicity induced by aminoglycosides manifests clinically as nonoliguric renal failure, with a slow rise in serum creatinine and a hypoosmolar urinary output developing after several days of treatment.
Do aminoglycosides cause ototoxicity?
Aminoglycoside antibiotics are widely used for the treatment of Gram negative sepsis. It is well known that they can cause dose related renal toxicity and ototoxicity, which occur in almost everyone who receives a sufficiently toxic dose.
Which antibiotics cause liver toxicity?
Antibiotic-associated DILIAntibioticIncidence and liver injuryFlucloxacillin1.8-3.6 per 100,000 prescriptions CholestaticAmoxicillin/ Clavulanic acid1-17 per 100,000 prescriptions Hepatocellular, cholestatic or mixedCeftriaxoneUp to 25% adults and 40% children develop cholelithiasis4 more rows
What are the common adverse effects of gentamicin?
Side EffectsAbdominal or stomach cramps or pain.agitation.back pain.black, tarry stools.blood in the urine.blurred or double vision.burning, numbness, tingling, or painful sensations.change in frequency of urination or amount of urine.More items...•
What is aminoglycoside toxicity?
The toxicities of aminoglycosides include nephrotoxicity, ototoxicity (vestibular and auditory) and, rarely, neuromuscular blockade and hypersensitivity reactions. Nephrotoxicity receives the most attention, perhaps because of easier documentation of reduced renal function, but it is usually reversible.
How do aminoglycosides damage kidneys?
They exert their main toxic effect within the tubular cell by altering phospholipid metabolism. In addition to their direct effect on cells, aminoglycosides cause renal vasoconstriction.
What medications interact with aminoglycosides?
The interaction of aminoglycoside antibiotics and calcium channel blockers is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnoea.
Which parts of the body may be damaged by aminoglycosides?
The major side effects of aminoglycosides are kidney injury, hearing impairment and vestibular toxicity.
Which aminoglycoside is most ototoxic?
Neomycin is considered the most highly toxic; followed by gentamicin, kanamycin, and tobramycin; while amikacin and netilmicin are considered the least toxic.
What drugs can cause ototoxicity?
Ototoxic medications known to cause permanent damage include certain aminoglycoside antibiotics, such as gentamicin (family history may increase susceptibility), and cancer chemotherapy drugs, such as cisplatin and carboplatin.
What causes hepatotoxicity?
Toxic liver disease is damage to your liver. It's also called hepatotoxicity or toxic hepatitis. It can cause serious symptoms or liver damage if you don't get help. Medications, herbal supplements, chemicals, solvents, and alcohol are all possible causes of hepatotoxicity.
Does gentamicin cause hepatotoxicity?
Hepatotoxicity. Intravenous and intramuscular therapy with gentamicin has been linked to mild and asymptomatic elevations in serum alkaline phosphatase levels, but rarely affects aminotransferase levels or bilirubin, and changes resolve rapidly once gentamicin is stopped.
Which anti TB drug is most hepatotoxic?
While isoniazid, rifampicin and pyrazinamide are known to cause hepatotoxicity, ethambutol and streptomycin are considered not to be hepatotoxic.
What are hepatotoxic medicines?
Drugs or toxins that have a pharmacological (type A) hepatotoxicity are those that have predictable dose-response curves (higher concentrations cause more liver damage) and well characterized mechanisms of toxicity, such as directly damaging liver tissue or blocking a metabolic process.
What Is an Aminoglycoside?
An aminoglycoside is a type of very powerful antibiotic used to treat serious bacterial infections. Aminoglycosides are especially useful in treating infections caused by certain gram-negative bacteria that are responsible for infections such as meningitis, tuberculosis, and plague. The very first aminoglycoside, streptomycin, was discovered in 1944. Today there are several other aminoglycosides: amikacin, gentamicin, kanamycin, neomycin, and tobramycin.
Why are aminoglycosides used in antibiotics?
Aminoglycosides are very useful antibiotics that help fight serious infections. But because they can hurt the patient as well as the bacteria, they are only used for certain serious infections.
Why do people take aminoglycoside antibiotics?
Many patients receive aminoglycoside antibiotics to treat infections . In this lesson, learn the names of the different aminoglycoside antibiotics and some of the problems a patient may experience when taking one of these antibiotics. Create an account.
Why do you need to watch for aminoglycosides?
And, patients who receive aminoglycosides must be watched carefully to prevent ototoxicity (problems with hearing and balance) and nephrotoxicity (problems with kidney function). To unlock this lesson you must be a Study.com Member. Create your account.
Can aminoglycosides kill bacteria?
But while aminoglycosides are working to kill the bad bacteria, they can also cause some serious toxic effects that can hurt the patient.
Does gentamicin cause rash?
During his treatment, Jack will be monitored very closely for side effects and toxicity caused by gentamicin. For example, Jack could experience an itchy rash, which is a common side effect that's usually not serious. On the other hand, Jack's kidneys and ears are very susceptible to damage from the gentamicin.
Is gentamicin bad for Jack's kidneys?
On the other hand, Jack's kidneys and ears are very susceptible to damage from the gentamicin. Aminoglycosides tend to concentrate in the little units inside the kidneys called nephrons. Because it can be toxic to the nephrons, the gentamicin Jack is receiving is a considered a potentially nephrotoxic antibiotic.
Sar of Aminoglycosides
Streptomycin, neomycin, gentamicin, paromomycin, sisomicin, ribostamycin, tobramycin, nebramycin, dibekacin, amikacin, and kanamycin are all aminocyclitol-containing antibiotics. Streptomyces and Micromonospora species produce them.
Mechanism of Action
They only need a brief contact period and are most successful against rapidly multiplying susceptible bacterial populations.
Types of Aminoglycosides
There are several different antibiotics in the aminoglycoside class. The US Food and Drug Administration (FDA) has approved gentamicin, tobramycin, amikacin, plazomicin, streptomycin, neomycin, and paromomycin for clinical use in the United States.
Clinical Use
The recent appearance of infections caused by Gram-negative bacterial strains with advanced antimicrobial resistance trends has led doctors to reconsider their use of these antibiotics.
Common Side Effects
Aminoglycosides are extremely powerful antibiotics with serious side effects, particularly when taken orally or intravenously.
Warnings and Precautions
If you're allergic to aminoglycosides or any of the inactive ingredients in these products, stay away from them.
What are the side effects of aminoglycosides?
Impairment of kidney function and hearing loss are the most common side effects of aminoglycosides. Aminoglycosides tend to be used when other less toxic antibiotics are contraindicated or ineffective. Aminoglycosides are not well absorbed when given by mouth, so need to be given by injection by healthcare personnel.
What are Aminoglycosides?
Aminoglycosides are a class of antibiotics used mainly in the treatment of aerobic gram-negative bacilli infections , although they are also effective against other bacteria including Staphylococci and Mycobacterium tuberculosis. They are often used in combination with other antibiotics.
Does aminoglycoside increase the kill rate?
Kill rates of bacteria are increased when higher concentrations of amino glycosides are present; however, the margin between a safe and a toxic dose is narrow and monitoring is often needed, although once daily dosing increases the safety window. Impairment of kidney function and hearing loss are the most common side effects of aminoglycosides.
Can aminoglycosides be absorbed by mouth?
Aminoglycosides are not well absorbed when given by mouth, so need to be given by injection by healthcare personnel.
What are the side effects of aminoglycosides?
The major side effects of aminoglycosides are kidney injury, hearing impairment and vestibular toxicity.
How to reduce nephrotoxicity of aminoglycosides?
Potential approaches include blocking tubular uptake, reducing the formation of reactive oxygen species (ROS), inhibiting cellular signalling leading to apoptosis, and enhancing the ability of the kidney to regenerate. These were outlined 10 years ago but have not yet been translated into clinical practice. 26
What is the role of gentamicin in apoptosis?
Cytosolic gentamicin either directly or indirectly (via ROS) causes the release of cytochrome C from the mitochondria, a key step in apoptosis. ROS cause an increase in the gene expression of oxidative stress-inducible genes, stress-inducible chaperones and oxido-reductive enzymes.
What is NAG in kidney?
Investigators have used biomarkers to obtain indirect evidence of subclinical kidney injury in many research settings. N-acetyl- β - d -glucosaminidase (NAG), one of the best characterised biomarkers, is a proximal tubular enzyme excreted in the urine in response to kidney damage. Paediatric patients with CF administered intravenous tobramycin have increased urinary NAG levels which remain elevated weeks after treatment. 13 However, patients taking inhaled gentamicin also have increased urinary NAG levels, 14 suggesting that the test is highly sensitive and may not indicate clinically important renal damage.
What is the role of aminoglycosides in CF?
Aminoglycoside antibiotics are a central component of the treatment of pulmonary exacerbations of cystic fibrosis (CF) and slow the decline in lung function which ultimately causes the death of most patients . The prognosis of CF has improved, and thus side effects of treatments have become increasingly important.
How does gentamicin affect the proximal tubular cell?
The effect of gentamicin on the proximal tubular cell is summarised in figure 1. After uptake, a number of cellular processes are activated, culminating in apoptosis. This contributes to loss of the renal tubular epithelium and thus kidney dysfunction but, conversely, shedding and urinary excretion of apoptotic bodies may excrete aminoglycosides.
Does tobramycin cause AKI?
The first report of AKI secondary to intravenous aminoglycosides in CF 7 was followed by several other cases and mini-series. Inhaled tobramycin has also been implicated. 8 Bertenshaw et al 9 conducted a national survey of AKI in patients with CF (AKI was pragmatically defined as an increased serum creatinine for age) and found that the incidence was 4.6–10.5/10 000 CF patients/year. A subsequent case–control study 10 established that an aminoglycoside in the previous week increased the risk of AKI >80-fold. Risk factors for renal impairment (including CF-related diabetes, non-steroidal anti-inflammatory drugs and acute dehydration) were strongly associated with AKI (OR 24.0). Exposure to gentamicin in the previous year was associated with AKI while exposure to tobramycin was not.
What are the side effects of a syringe injection?
pain at the injection site. purple spots on the skin. redness of the skin. swelling or inflammation of the mouth. tunnel vision. unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness. Managing side effects (general information)
What are the side effects of gentamicin?
Check with your doctor or nurse immediately if any of the following side effects occur while taking gentamicin: Incidence not known. Abdominal or stomach cramps or pain. agitation. back pain. black, tarry stools. blood in the urine.
Is aminoglycoside ototoxic?
Monitor renal and auditory function during therapy and discontinue therapy or adjust dose if there is evidence of ototoxicity or nephrotoxicity. Aminoglycoside-induced ototoxicity is usually irreversible. Serum concentrations of aminoglycosides should be monitored when feasible to assure adequate levels and to avoid potentially toxic levels. Concurrent use of other potentially neurotoxic or nephrotoxic agents, or potent diuretics should be avoided. Aminoglycosides can cause fetal harm when administered to a pregnant woman.
Is aminoglycoside ototoxicity irreversible?
Aminoglycoside-induced ototoxicity is usually irreversible. Serum concentrations of aminoglycosides should be monitored when feasible to assure adequate levels and to avoid potentially toxic levels. Concurrent use of other potentially neurotoxic or nephrotoxic agents, or potent diuretics should be avoided.
