Aminoglycosides · Pharmacology

What is the primary reason aminoglycosides are not effective when administered orally for systemic infections?

  1. They are completely destroyed by gastric acid before absorption
  2. They undergo near-complete first-pass metabolism in the hepatic portal circulation
  3. They bind to calcium in the diet, forming insoluble complexes
  4. They are highly polar cations and are not absorbed across the GI mucosa
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Correct answer: They are highly polar cations and are not absorbed across the GI mucosa

Aminoglycosides are polycationic and highly polar. This prevents them from diffusing across the lipid membranes of the gastrointestinal tract, necessitating parenteral (IM or IV) administration for systemic effect.

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