6. Compare the activity of the beta-lactam antibiotics and the aminoglycosides 7

Question

6. Compare the activity of the beta-lactam antibiotics and the aminoglycosides

7. Nephrotoxicity and ototoxicity are serious side effects of the aminoglycosides. Describe these conditions. Describe two nursing interventions that will reduce the incidence of these conditions.

8. What foods and drugs interfere with absorption of oral tetracycline? How can interference be prevented or minimized?

9. Describe “red man syndrome”. What is the primary nursing consideration in preventing this effect of Vancomycin administration?

10. Increased drug resistance has complicated the use and usefulness of antibiotics. List 3 guidelines to decrease the chance of resistance.

Explanation / Answer

6.Activity of bacteriocidal -lactam antibiotics are generally linked to the structure of bacterial cell and inhibit the sysnthesis of peptydoglycon layer of bacterial cell in which the activate an autolytic system that causes cell death.

Bacteriocidal aminoglycosides are binding tightly to the aminoacyl site of 16S ribosomal RNA within the 30S ribosomal subunit and inhibt their protein synthesis that lead to misreading of the genetic code and inhibition of translocation .

7. Aminoglycoside is capable of inducing both nephrotoxicity and ototoxicity.

Aminoglycosides are nephrotoxic because a small but large proportion of the administered dose is remained in the epithelial cells and is surrounded primarily to the S1 and S2 segments of the proximal tubule after glomerular filtration .Nephrotoxicity caused by aminoglycosides manifest in which in the serum creatinine concentration rise to more than 0.5 to 1 mg/dL from baseline occurring in 10 to 20 percent of patients .

Ototoxicity is caused due aminoglycosides that damage to the inner ear and resulting in damage to the hearing organs and lead to temporary or permanent hearing loss. Cochlear and vestibular toxicity are associated with aminoglycosides if it takes for prolonged periods.

Clinical strategies that reduce the potential for nephrotoxicity and ototoxicity include:

8. Tetracycline should be taken with a glass of water either one hour before or two hours after meals. It is not taken with milk or other milk product because it binds calcium and iron, aluminium and magnesium that interfere with their absorption by 50 to 90% or even more.

This interference is minimized by taking ferrous sulphate together with tetracycline and three of its derivatives such as -oxytetracycline, methacycline, and doxycycline that reduce the absorption of these antibiotics.

9. Red man syndrome is a type of hypersensitivity reaction that caused by caused by a peculiar reaction of vancomycin .It is also known as ‘’red neck syndrome’’.

There are several treatments that is available for preventing Red Man Syndrome. Some of them include:

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