What is 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.
Which aminoglycoside is most nephrotoxic?
Choice of aminoglycoside The following rank order of nephrotoxicity has been reported, from most toxic to least toxic: neomycin > gentamicin ≥ tobramycin ≥ amikacin ≥ netilmicin > streptomycin [1].
Which aminoglycoside is least nephrotoxic?
Among these treatment groups, tobramycin was the least nephrotoxic of the aminoglycosides.
How can nephrotoxicity of aminoglycosides be reduced?
To minimize the risk of nephrotoxicity, select loading and maintenance aminoglycoside dosages based on estimated creatinine clearance. Also, monitor peak and trough serum aminoglycoside levels, replenish volume, and correct potassium and magnesium abnormalities.
Why aminoglycosides are contraindicated in renal failure?
[10] The well known nephrotoxic potential of aminoglycosides has lead physicians to reduce the dosage of the drug. The risk of insufficient bactericidal effect as a result of under dosing has been demonstrated in renal failure patients.
How can nephrotoxicity be prevented?
General preventive measures to avoid nephrotoxicity include using alternative nonnephrotoxic drugs; correcting risk factors; assessing baseline renal function before initiation of therapy, followed by adjusting the dosage; monitoring renal function and vital signs during therapy; and avoiding nephrotoxic drug …
How do aminoglycosides cause ototoxicity?
Aminoglycosides appear to generate free radicals within the inner ear, with subsequent permanent damage to sensory cells and neurons, resulting in permanent hearing loss. Two mutations in the mitochondrial 12S ribosomal RNA gene have been previously reported to predispose carriers to aminoglycoside-induced ototoxicity.
What are the contraindications 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.
What are the characteristics of aminoglycoside nephrotoxicity?
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.
How can aminoglycoside-induced nephrotoxicity be prevented?
(ii) Prevention of aminoglycoside binding to phospholipids. Polyaspartic acid has emerged as a very successful protectant against aminoglycoside-induced nephrotoxicity from the screening of various polymers that are likely to impair the binding of aminoglycosides to kidney membrane vesicles (142).
What is the pathophysiology of aminoglycoside toxicity?
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.
What is the most common cause of drug-induced nephrotoxicity?
Aminoglycosides have long been one of the commonest causes of drug-induced nephrotoxicity (137).