So today we are digging into our pharmacology books our resources here to learn a little bit
more about aminoglycoside. So from a nursing perspective what do we need to know when we
are giving these medications to our patients and I've got some fun tips coming up for you,
and of course, stay till the end because we're going to have an NCLEX question to help you
apply the learning in today's lesson. Welcome back my name is Tammy and this is NurseMinder
and on this channel we do everything nursing so if you're new here consider subscribing below so
that you get the next video when it's released. Okay so we're talking about aminoglycosides,
we're actually focusing on the protein synthesis that's happening inside the cell so let me give
you an example in everyday life that might make sense. So I first wanted to share with you how
amino glycosides work and I'm going to share it with the story about Amy - Amy's in the
photocopier room and what she's doing is she has a piece of paper that she's photocopying
and she's creating exact duplicates of the original piece of paper. Now that's really what's
happening inside of our cell when the proteins continue to replicate so that the cell can do
its function, its job, it needs these proteins to do its job. Now all of a sudden what happens
is we have this bacteria come into the cell and gives her a different piece of paper to photocopy
so she does her job and she's photocopying. Well this new piece of paper happens to be an illness
and it's going to cause harm to the body now aminoglycosides come in and it's like a paper jam
inside the photocopier. It halts the ability of the cell to continue to replicate this protein
and if we can't replicate the protein, then the cell can't do its job and it will eventually
die. So first of all let's identify what is an aminoglycoside. This is an easy category
because the naming of the drugs they all have a similar suffix, so the ending of the word ends in
-mycin so we have gentamicin, streptomycin, tobramycin, neomycin, and amikacin where you see
that the mycin is in the word it's just separated a little bit. Now I put them in this order for a
reason and I want you to think of ants when it comes to aminoglycosides, because ants are small
and when they bite they cause itchy rashes and that is one of the side effects of aminoglycosides
is that they can have a hypersensitivity to the drug and end up developing a rash.
Now in terms of ants what do we want to do? We want to get rid of them so we're going to step
on them okay. So these are some of the diagnoses you might see when it comes to
my patients on an aminoglycoside - why do they have it? So do they have a staph aureus
infection? Do they have tuberculosis and this is being used in combination with other drugs
to treat it? Is it E coli, pseudomonas aeruginosa, sorry. So step on the ants
is aminoglycosides. Okay plus we also have the klebsiella pneumonia as well here.
Now let's get into a really cool way to remember a few more things about aminoglycosides.
First of all I've got the no in a box here and that's for several reasons
these diagnoses all have something in common:
gram-negative bacteria and so that's the first hint that you can use - the word - I love it
when a word gives me clues as to what it does I mean no means gram-negative so this would not
be - you would not see aminoglycoside to treat a gram-positive illness okay. so gram-negative.
Now the other things that we can use the word no for are to help us identify side effects:
and oh
there are black label warnings for these drugs because they have been known to create
nephrotoxicity and ototoxicity and if a
pregnant mom - so you want to be giving these in pregnancy either so no pregnancy
nephrotoxic, ototoxic, no pregnancy, gram-negative medication. Don't you love a word that gives you
all these clues? Now another note is that they are typically not given orally so not orally, however,
I'm going to just put a little star here beside the neo - neo doesn't like the word no so
this is how I remember; neo-neo can also be given orally okay, but generally,
they are given intramuscularly, intravenously, and again the word amino has the clues in it.
So 'im' intramuscularly, 'in' intravascularly and then of course occasionally orally and ophthalmic;
they can be given as drops and topical. All right so amino is given a lot of clues as
to how these drugs are given now one of the most important things that this word gives us is how it
works - no protein synthesis; that's the photocopy jam in the photocopier with Amy right. So here we
have Amy working in the photocopier room and all of a sudden gets a jam because there is no
more protein synthesis. This is the mechanism of action as to how aminoglycosides work inside the
cell - they halt protein synthesis which means the cell cannot function and the cell will die.
We know that these will only work in gram-negative bacteria so staph aureus,
we're going to step on these ants, staph aureus, tuberculosis, E Coli, Pseudomonas aeruginosa,
and then, of course, we're adding klebsiella pneumonia that's one you have to add to your step.
uh we also know that it is going to cause nephrotoxicity and cytotoxicity;
major side effects to watch for and because we have these ants over here we know they can
cause a rash as well so big one to know. Pretty easy right? Let's get on to our NCLEX question.
Okay question number one: be sure to pause this after the question is read, consider the answers
and then return to us. Your patient has a history of cystic fibrosis and is now being treated for a
new diagnosis of pseudomonas aeruginosa. Which medication do you anticipate will be ordered?
Amikacin, gentamicin, streptomycin, or tobramycin? Go ahead and pause this video. Okay
now you may have paused this video and gone back to check this out because this was a bonus piece
of information I snuck in there - and the answer would be tobramycin. Let's go on to quiz number
two: All right in this question your patient is diagnosed with E coli and prescribed amikacin 250
milligrams iv twice a day and he received his first dose last evening. Today he complains of
hearing loss. Which medication on his profile is most likely to increase the risk of cytotoxicity?
furosemide, metformin, acetaminophen, or rantidine? Go ahead and pause this video make
your selection. Okay you ready? So the answer here would be furosemide. Furosemide is a loop diuretic
and in the video, we talked about how diuretics given with aminoglycosides can increase the risk
for nephrotoxicity and ototoxicity. Thanks for watching. Hit the subscribe button,
make sure you stay connected with me so that you get the notification when the next
video is released, bell, like and of course share this with your friends. There's a lot
of ways in which we can help each other through nursing school and nursing practice and learning
these quick little pneumonics and tips and tricks really help to expedite our process.
All right also let me know in the comments below if this has been helpful. If you have any other
mnemonics that you use share that below because obviously we're stronger together when we combine
our knowledge and our wisdom and experience. We'll see you in the next video. Hey I know
you're probably not ready to get off your phone or go back to work just yet or maybe even turn the
lights off to go to sleep so why don't you spend a little bit more time here watching another video
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