A 69-year-old man with gram-negative sepsis is treated with gentamicin 5 mg/kg IV daily. After 5 days, he develops rising serum creatinine (2.8 mg/dL) and vertigo with ataxia. Vital signs show BP 128/76, HR 92, RR 18, temperature 37.2°C, and SpO2 98% on room air. Urinalysis reveals muddy brown casts. He denies hearing loss. Which of the following best describes gentamicin's mechanism of action?
- A)Irreversible binding of the 30S ribosomal subunit causing misreading of mRNAGABARITO
- B)Inhibition of dihydropteroate synthase
- C)Reversible binding of the 50S ribosomal subunit to block translocation
- D)Blockade of peptidoglycan cross-linking by penicillin-binding proteins
- E)Inhibition of DNA dependent RNA polymerase
Explicação
Aminoglycosides such as gentamicin irreversibly bind the 30S ribosomal subunit, inhibiting initiation complex formation and causing misreading of mRNA. Nephrotoxicity and ototoxicity are classic adverse effects, which fit this patient's kidney injury and vesti... Ver explicação completa e trilha adaptativa →