RLO: Pharmacokinetic and Pharmacodynamic Influences of Aminoglycoside Dosing

Distribution 2

Higher concentrations of aminoglycosides only exist within specialised cells that contain active transport mechanisms, such as the hair cells of the ears and the tubular cells of the renal cortex.

These active transport mechanisms are saturable. Therefore, higher extracellular aminoglycoside concentrations do not necessarily correspond to greater concentrations within the specialised cells.

It is important that the serum aminoglycoside levels are allowed to fall, so that the aminoglycosides can redistribute out of these cells. If serum levels are not allowed to fall, and high intracellular concentrations persist for long periods, toxicity, leading to cell death, ototoxicity and nephrotoxicity will occur.

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